Dihydrotestosterone is a predictor for mortality in males with community-acquired pneumonia: results of a 6-year follow-up study
Abstract Background Adrenal hormone metabolite levels are altered in acute illnesses such as community-acquired pneumonia (CAP). Our aim was to investigate associations of sex and mineralocorticoid hormone metabolites with short- and long-term mortality and severity of CAP in male and female patient...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12931-018-0947-0 |
| _version_ | 1819290011273527296 |
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| author | Seline Zurfluh Manuela Nickler Manuel Ottiger Christian Steuer Alexander Kutz Mirjam Christ-Crain Werner Zimmerli Robert Thomann Claus Hoess Christoph Henzen Luca Bernasconi Andreas Huber Beat Mueller Philipp Schuetz for the proHOSP study group |
| author_facet | Seline Zurfluh Manuela Nickler Manuel Ottiger Christian Steuer Alexander Kutz Mirjam Christ-Crain Werner Zimmerli Robert Thomann Claus Hoess Christoph Henzen Luca Bernasconi Andreas Huber Beat Mueller Philipp Schuetz for the proHOSP study group |
| author_sort | Seline Zurfluh |
| collection | DOAJ |
| description | Abstract Background Adrenal hormone metabolite levels are altered in acute illnesses such as community-acquired pneumonia (CAP). Our aim was to investigate associations of sex and mineralocorticoid hormone metabolites with short- and long-term mortality and severity of CAP in male and female patients. Methods We prospectively followed 285 patients (60.4% male, mean age 71 years) with CAP from a previous multicenter trial. At baseline, levels of different metabolites of sex hormones and mineralocorticoids were measured by liquid chromatography coupled to tandem mass spectrometry. We calculated Cox regression models adjusted for age and comorbidities. Results All-cause mortality was 5.3% after 30 days and increased to 47.4% after 6 years. In males, high levels of dihydrotestosterone were associated with higher 6-year mortality (adjusted HR 2.84, 95%CI 1.15–6.99, p = 0.023), whereas high levels of 17-OH-progesterone were associated with lower 6-year mortality (adjusted HR 0.72, 95%CI 0.54–0.97, p = 0.029). Testosterone levels in males correlated inversely with inflammatory markers (CRP rho = − 0.39, p < 0.001; PCT rho = − 0.34, p < 0.001) and disease severity as assessed by the Pneumonia severity index (PSI) (rho = − 0.23, p = 0.003). No similar association was found for female patients. Conclusion Whereas in males with CAP, sex and mineralocorticoid hormone metabolite levels correlated with inflammation, disease severity and long-term survival, no similar association was found for females. Further study of sex and mineralocorticoid hormones in acute illness could generate predictive signatures with implementation in clinical practice. |
| first_indexed | 2024-12-24T03:15:57Z |
| format | Article |
| id | doaj.art-647a1affaac84d0b845ecf6f25e746f5 |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-12-24T03:15:57Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-647a1affaac84d0b845ecf6f25e746f52022-12-21T17:17:38ZengBMCRespiratory Research1465-993X2018-12-0119111010.1186/s12931-018-0947-0Dihydrotestosterone is a predictor for mortality in males with community-acquired pneumonia: results of a 6-year follow-up studySeline Zurfluh0Manuela Nickler1Manuel Ottiger2Christian Steuer3Alexander Kutz4Mirjam Christ-Crain5Werner Zimmerli6Robert Thomann7Claus Hoess8Christoph Henzen9Luca Bernasconi10Andreas Huber11Beat Mueller12Philipp Schuetz13for the proHOSP study groupMedical University Department, Division of General Internal and Emergency MedicineMedical University Department, Division of General Internal and Emergency MedicineMedical University Department, Division of General Internal and Emergency MedicineETH ZürichMedical University Department, Division of General Internal and Emergency MedicineDepartment of Internal Medicine, Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital BaselBasel University Medical Clinic LiestalDepartment of Internal MedicineDepartment of Internal Medicine, Kantonsspital MünsterlingenDepartment of Internal MedicineDepartment of Laboratory MedicineDepartment of Laboratory MedicineMedical University Department, Division of General Internal and Emergency MedicineMedical University Department, Division of General Internal and Emergency MedicineAbstract Background Adrenal hormone metabolite levels are altered in acute illnesses such as community-acquired pneumonia (CAP). Our aim was to investigate associations of sex and mineralocorticoid hormone metabolites with short- and long-term mortality and severity of CAP in male and female patients. Methods We prospectively followed 285 patients (60.4% male, mean age 71 years) with CAP from a previous multicenter trial. At baseline, levels of different metabolites of sex hormones and mineralocorticoids were measured by liquid chromatography coupled to tandem mass spectrometry. We calculated Cox regression models adjusted for age and comorbidities. Results All-cause mortality was 5.3% after 30 days and increased to 47.4% after 6 years. In males, high levels of dihydrotestosterone were associated with higher 6-year mortality (adjusted HR 2.84, 95%CI 1.15–6.99, p = 0.023), whereas high levels of 17-OH-progesterone were associated with lower 6-year mortality (adjusted HR 0.72, 95%CI 0.54–0.97, p = 0.029). Testosterone levels in males correlated inversely with inflammatory markers (CRP rho = − 0.39, p < 0.001; PCT rho = − 0.34, p < 0.001) and disease severity as assessed by the Pneumonia severity index (PSI) (rho = − 0.23, p = 0.003). No similar association was found for female patients. Conclusion Whereas in males with CAP, sex and mineralocorticoid hormone metabolite levels correlated with inflammation, disease severity and long-term survival, no similar association was found for females. Further study of sex and mineralocorticoid hormones in acute illness could generate predictive signatures with implementation in clinical practice.http://link.springer.com/article/10.1186/s12931-018-0947-0Community-acquired pneumoniaAdrenal hormonesDihydrotestosteroneMortality prediction |
| spellingShingle | Seline Zurfluh Manuela Nickler Manuel Ottiger Christian Steuer Alexander Kutz Mirjam Christ-Crain Werner Zimmerli Robert Thomann Claus Hoess Christoph Henzen Luca Bernasconi Andreas Huber Beat Mueller Philipp Schuetz for the proHOSP study group Dihydrotestosterone is a predictor for mortality in males with community-acquired pneumonia: results of a 6-year follow-up study Respiratory Research Community-acquired pneumonia Adrenal hormones Dihydrotestosterone Mortality prediction |
| title | Dihydrotestosterone is a predictor for mortality in males with community-acquired pneumonia: results of a 6-year follow-up study |
| title_full | Dihydrotestosterone is a predictor for mortality in males with community-acquired pneumonia: results of a 6-year follow-up study |
| title_fullStr | Dihydrotestosterone is a predictor for mortality in males with community-acquired pneumonia: results of a 6-year follow-up study |
| title_full_unstemmed | Dihydrotestosterone is a predictor for mortality in males with community-acquired pneumonia: results of a 6-year follow-up study |
| title_short | Dihydrotestosterone is a predictor for mortality in males with community-acquired pneumonia: results of a 6-year follow-up study |
| title_sort | dihydrotestosterone is a predictor for mortality in males with community acquired pneumonia results of a 6 year follow up study |
| topic | Community-acquired pneumonia Adrenal hormones Dihydrotestosterone Mortality prediction |
| url | http://link.springer.com/article/10.1186/s12931-018-0947-0 |
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