Testosterone, IGF-1, DHEA-S, and health parameters were evaluated in a representative sample of 410 men aged 65 years and older. A total of 126 men died during the 6-year follow-up.

Thresholds for lowest-quartile definitions were:

bioavailable testosterone 70 ng/dL or below

IGF-1 63.9 ng/mL or below

DHEA(S) 50 microg/dL or below

Men were divided into 4 groups: no hormone in the lowest quartile range (reference) and 1, 2, and 3 hormones in the lowest quartiles.


Compared with men with levels of all 3 hormones above the lowest quartiles, having 1, 2, and 3 hormones in the lowest quartile was associated with an increased risk of death by 47%, 85% and 229% respectively.

In the fully adjusted analysis, only men with 3 anabolic hormone deficiencies had a significant 244%, almost a 2.5-fold, increase in mortality.


This study shows that the risk of death increases progressively with the number of anabolic hormone deficiencies, and becomes close to 2.5 times higher when 3 anabolic hormones are in the low range, compared with no anabolic hormone in the low range. [22]

Independent of age and several confounding factors (obesity, inflammatory status, physical activity, caloric and alcohol intake, smoking, and pre-existing diseases), low circulating levels of the anabolic hormones testosterone, IGF-1, and DHEA(S) were an independent predictor of mortality during 6 years of follow-up in older men. On the contrary, blood levels of each of these hormones considered separately were much less associated with mortality.

Thus, the age-associated decline in anabolic hormone levels is a strong independent predictor of mortality in older men. Having multiple hormonal deficiencies rather than a deficiency in a single anabolic hormone, is a robust biomarker of health status and risk of death in older persons. This underscores the importance of monitoring and correcting all  hormonal deficiencies, and not just focusing on a single hormone.


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