Hormones sexuelles et mortalité chez les hommes au cours du vieillissement dans l’étude de cohorte des Trois Cités

Abstract : Despite a number of studies regarding the association of endogenous sex steroid hormones with mortality in men, the results remain controversial and could depend on the characteristics of the subjects and the cause of death. Using the data from the prospective ThreeCity cohort study set-up in France, we investigated the role of endogenous testosterone and estradiol on 12-year mortality in men over 65 years, taking into account the clinical and genetic background, as well as the cause-specific of death. Firstly, we found a significant interaction of testosterone with metabolic syndrome (MetS) on mortality. Low levels of testosterone were associated with an increased risk of mortality among men suffering from MetS while there was no association of hormone with death in healthy subjects. Then, we showed that high levels of testosterone increased the risk of death from cardiovascular disease but not from cancer or other cause in healthy men. Finally, we highlighted a quadratic association between endogenous estradiol and all-cause mortality. This relationship was not modified by genetic polymorphisms of estrogen receptors but could depend on the cause of death. A stronger quadratic association was found with cardiovascular disease mortality but estradiol did not influence the risk of cancer or other cause of mortality. In conclusion, this thesis confirmed the complex role of endogenous sex steroid hormones on mortality in men and allowed to better understand previous controversial results. If confirmed, these results could help identifying subgroups at high risk, improving the clinical and therapeutic management of men during aging.
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Abdel Nasser Laouali Mahamadou. Hormones sexuelles et mortalité chez les hommes au cours du vieillissement dans l’étude de cohorte des Trois Cités. Santé publique et épidémiologie. Université Paris-Saclay, 2018. Français. ⟨NNT : 2018SACLS226⟩. ⟨tel-02182944⟩

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