Associations of androgens with depressive symptoms and cognitive status in the general population

<div><p>Objectives</p><p>Associations between androgens and depressive symptoms were mostly reported from cross-sectional and patient-based studies.</p><p>Study design/main outcome measures</p><p>Longitudinal data from 4,110 participants of the Study of Health in Pomerania were used to assess <b>se</b>x-specific associations of baseline total and free testosterone, androstenedione and sex hormone-binding globulin with incident depressive symptoms and cognitive status at 5- and 10-year follow-up.</p><p>Results</p><p>Despite sex-specific differences in depressive symptoms prevalence at baseline (women: 17.4%, men: 8.1%), cross-sectional analyses showed no associations between sex hormones and depressive symptoms. In age-adjusted longitudinal analyses, total testosterone was associated with incident depressive symptoms (relative risk at 5-year follow-up: 0.73, 95% confidence interval: 0.58–0.92). Similarly, age-adjusted analyses showed a positive association between sex hormone-binding globulin and cognitive status in men (β-coefficient per standard deviation: 0.44, 95% confidence interval: 0.13–0.74). In women, age-adjusted associations of androstenedione with baseline depressive symptoms (relative risk: 0.88, 95% confidence interval: 0.77–0.99) were found. None of the observed associations remained after multivariable adjustment.</p><p>Conclusions</p><p>The present population-based, longitudinal study revealed inverse associations between sex hormones and depressive symptoms. However, the null finding after multivariable adjustment suggests, that the observed associations were not independent of relevant confounders including body mass index, smoking and physical inactivity. Furthermore, the low number of incident endpoints in our non-clinical population-based sample limited the statistical power and reduced the chance to detect a statistically significant effect.</p></div

Baseline characteristics of the study population, stratified by sex.

<p>Baseline characteristics of the study population, stratified by sex.</p

Depressive symptoms prevalence at baseline by specific subgroups.

<p>Low total testosterone was defined as <10.4 nmol/L. TT, total testosterone; T2DM, type 2 diabetes mellitus.</p

Associations of sex hormones and SHBG with change in mini mental status in linear regression models, separately in men and women.

<p>Associations of sex hormones and SHBG with change in mini mental status in linear regression models, separately in men and women.</p

Associations of sex hormones and SHBG with depressive symptoms in Poisson regression models, separately in men and women.

<p>Associations of sex hormones and SHBG with depressive symptoms in Poisson regression models, separately in men and women.</p

Association between sex hormones and anthropometry in men and women.

<p>Association between sex hormones and anthropometry in men and women.</p

Associations of sex hormones with leptin.

<p>Analysis of testosterone, estrone, androstendione, and dehydroepiandrosterone-sulfate (DHEAS) with body-mass-index (BMI) and leptin among men (upper part) and women (lower part). Linear regression adjusted for age, sex, smoking, physical activity, type 2 diabetes mellitus, hypertension, and cholesterol.</p

Baseline characteristics of the study population, stratified by sex.

<p>Baseline characteristics of the study population, stratified by sex.</p

MRI post-processing figure depicting the fat quantification pipeline.

<p>Subcutaneous adipose tissue is highlighted red, visceral adipose tissue is highlighted green, other fat tissue is highlighted yellow.</p

Flow chart of the study sample.

<p>DHEAS, dehydroepiandrosterone-sulfate; SHBG, sex hormone-binding globulin; Anatomical Therapeutic Chemical Classification System Code for Urologicals: LO2B and for Testosterone-5-alpha-reductase-inhibitors: G04CB.</p