Effects of Testosterone Administration on Fat Distribution, Insulin Sensitivity, and Atherosclerosis Progression (original) (raw)
Related papers
Arteriosclerosis, Thrombosis, and Vascular Biology, 1991
Although levels of high density lipoprotein (HDL) cholesterol in males decrease during adolescence and after treatment with testosterone derivatives, several studies have reported that levels of HDL cholesterol are positively associated with endogenous levels of testosterone in men. This association was further examined using data collected during 1985 and 1986 from 3,562 white and 500 black men who ranged in age from 31 to 45 years. Black men had higher mean levels of both HDL cholesterol (8 mg/dl) and total testosterone (33 ng/dl) than white men, and positive associations were observed between testosterone and HDL cholesterol levels (r=0.22, whites; r=0.26, blacks). In addition, levels of testosterone were related positively to alcohol consumption and cigarette smoking and negatively to age, Quetelet index, and use of 0-blockers. We used stratification and regression analyses to determine if any of these characteristics could account for the positive association between levels of HDL cholesterol and total testosterone. Although controlling for most factors had little influence, adjusting for Quetelet index reduced the strength of the association between levels of testosterone and HDL cholesterol by approximately 30%. These findings suggest that the positive association between levels of testosterone and HDL cholesterol may not be causal. Multivariable analyses that control for obesity and other potentially confounding characteristics should be used in studies that assess the relation of testosterone levels to coronary heart disease. (Arteriosclerosis and Thrombosis 1991;ll:307-315) M iddle-aged men in industrialized countries are at a threefold to 10-fold higher risk for coronary heart disease (CHD) than are women. 1 Several investigators 1 " 3 have assessed possible determinants of this sex differential, and it has been suggested that sex hormones play an important role, possibly through their regulation of lipoprotein metabolism. During adulthood, premenopausal women have higher levels of high density lipoprotein (HDL) cholesterol but lower levels of triglycerides and low density lipoprotein (LDL) cholesterol than do men. 4 From the Agent Orange Projects (D.S.F., W.D.F.
Endogenous testosterone and serum lipids in middle-aged men
Atherosclerosis, 2008
Background: The role of decreasing testosterone levels influencing lipid metabolism in aging men is not well established. Methods: We studied 1619 40 to 69-year old men with andropausal symptoms, who underwent measurements of serum testosterone, triglycerides, total-, and HDL-cholesterol. Results: Testosterone (mean 15.25 nmol/l ± 5.43 S.D., range 3.6-45.0 nmol/l) correlated directly with HDL-cholesterol (r = 0.24, p < 0.0001) and inversely with total cholesterol (r = −0.06, p < 0.03), triglycerides (r = −0.30, p < 0.0001) and body mass index (r = −0.34, p < 0.0001), but not with LDL-cholesterol (r = 0.05, p = 0.09). In multivariate analyses adjusted for age, body mass index, smoking, alcohol consumption, diabetes and cardiovascular diseases, the significant determinants for serum triglycerides were testosterone (β = −0.03, p < 0.0001), age (β = −0.01, p < 0.0001), body mass index (β = 0.039, p < 0.0001) and cardiovascular diseases (β = 0.09, p < 0.04). The multivariate correlates of HDL-cholesterol included testosterone (β = 0.007, p < 0.0001), body mass index (β = −0.02, p < 0.0001) and alcohol consumption (β = 0.02, p < 0.0001). Conclusions: We conclude that in aging men low testosterone levels are associated with a potentially atherogenic lipid profile including high triglycerides and low HDL-cholesterol.
Reviews in Endocrine and Metabolic Disorders, 2021
The cardiovascular (CV) benefit and safety of treating low testosterone conditions is a matter of debate. Although testosterone deficiency has been linked to a rise in major adverse CV events, most of the studies on testosterone replacement therapy were not designed to assess CV risk and thus excluded men with advanced heart failure or recent history of myocardial infarction or stroke. Besides considering observational, interventional and prospective studies, this review article evaluates the impact of testosterone on atherosclerosis process, including lipoprotein functionality, progression of carotid intima media thickness, inflammation, coagulation and thromboembolism, quantification of plaque volume and vascular calcification. Until adequately powered studies evaluating testosterone effects in hypogonadal men at increased CV risk are available (TRAVERSE trial), clinicians should ponder the use of testosterone in men with atherosclerotic cardiovascular disease and discuss benefit ...
American Journal of Epidemiology, 1997
The present study examined lifestyle and behavioral correlates of the change in total testosterone over 13 years in 66 men aged 41-61 years who were former participants of the Multiple Risk Factor Intervention Trial (MRFIT) at the Pittsburgh, Pennsylvania, center. The authors also determined in these men if changes in total testosterone are related to changes in cardiovascular disease risk factors. The mean total testosterone level was 751 (standard deviation, 248) ng/dl at baseline and decreased by 41 (standard deviation, 314) ng/dl during follow-up. The correlation between measures was r = 0.44 (p < 0.001). In multivariate analysis, higher type A coronary-prone behavior score, greater pack-years of cigarette smoking, and the MRFIT special intervention group were associated with larger decreases in total testosterone. Age, body weight, weight change, leisure time activity level, and alcohol intake were not related to the change in total testosterone. The decrease in endogenous testosterone was associated with an increase in triglycerides and a decrease in high density lipoprotein cholesterol in multivariate analysis controlling for obesity and other lifestyle covariates. There was little relation between change in testosterone and change in total and low density lipoprotein cholesterol or blood pressure. This longitudinal study confirms a gradual decline in total testosterone levels with advancing age in older men and provides evidence that lifestyle and psychosocial factors are related to this decline. Decreases in endogenous testosterone levels with age in men are associated with potentially unfavorable changes in triglycerides and high density lipoprotein cholesterol.
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2002
Background. Sex hormones are known to affect cholesterol levels and vascular tone in women. The effects of testosterone on cholesterol and vascular tone in men are less well understood. Low testosterone levels have been associated with higher cholesterol levels in epidemiologic studies, but testosterone replacement has resulted in variable changes in cholesterol levels. Similarly, clinical studies suggest that testosterone may be vasodilatory, but few studies have directly evaluated the effects of testosterone on vascular tone. Methods. Sixty-seven men (mean age 76 Ϯ 4 years, range 65-87) with bioavailable testosterone levels below 4.44 nmol/l (lower limit for adult normal range) were randomized to receive transdermal testosterone (2-2.5 mg patches/d) or placebo patches for 1 year. Twenty-three men (34%) withdrew from the study; 44 men completed the trial. Results. While total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels did not significantly change during the year of therapy, high-density lipoprotein (HDL) levels (p ϭ .004) and, specifically, HDL 2 subfraction (p ϭ .02) decreased in men receiving testosterone supplementation. Vascular tone was measured by brachial artery reactivity in 36 men. Endothelium-dependent brachial artery reactivity did not change from baseline measurements in men receiving transdermal testosterone (0.3 Ϯ 6.7% to 1.6 Ϯ 4.6%; p ϭ .58) or in the placebo group (3.2 Ϯ 5.5% to 0.7 Ϯ 5.5%; p ϭ .23). Conclusions. Transdermal testosterone decreased HDL 2 cholesterol but did not affect vascular reactivity in men older than 65 years selected for low testosterone levels. No study to date has addressed the direct relationship between testosterone replacement and cardiovascular events.
CLINICAL …, 2005
Objectives Ageing in men is associated with a gradual decline in serum testosterone levels and a concomitant loss of muscle mass, accumulation of central adiposity, impaired mobility and increased risk of bone fractures. Whether androgen treatment might be beneficial in these subjects is still under debate. We have carried out a systematic review of randomized controlled trials (RCTs) evaluating the effects of testosterone (T) administration to middle-aged and ageing men on body composition, muscle strength, bone density, markers of bone metabolism and serum lipid profile. Data source A comprehensive search of all published randomized clinical trials was performed using the MEDLINE, Cochrane Library, EMBASE and Current Contents databases. Review methods Guided by prespecified criteria, software-assisted data abstraction and quality assessed by two independent reviewers, 29 RCTs were found to be eligible. For each investigated variable, we reported the results of pooled estimates of testosterone treatment using the random effect model of meta-analysis. Heterogeneity, reproducibility and consistency of the findings across studies were explored using sensitivity and meta-regression analysis. Results Overall, 1083 subjects were evaluated, 625 randomized to T, 427 to placebo and 31 to observation (control group). Weighted mean age was 64·5 years (range 49·9 -77·6) and mean serum testosterone was 10·9 nmol / l (range 7·8 -19). Testosterone treatment produced: (i) a reduction of 1·6 kg (CI: 2·5 -0·6) of total body fat, corresponding to − 6·2% (CI: 9·2 -3·3) variation of initial body fat, (ii) an increase in fat free mass of 1·6 kg (CI: 0·6 -2·6), corresponding to +2·7% (CI: 1·1 -4·4) increase over baseline and (iii) no change in body weight. The effects of T on muscle strength were heterogeneous, showing a tendency towards improvement only at the leg/knee extension and handgrip of the dominant arm (pooled effect size = 0·3 standard mean difference (SMD), CI: − 0·0 to 0·6). Testosterone improved bone mineral density (BMD) at the lumbar spine by +3·7% (CI: 1·0 -6·4%) compared to placebo, but not at the femoral neck, and produced a consistent reduction in bone resorption markers (pooled effect size = − 0·6 SMD, CI: − 1·0 to − 0·2). Testosterone also reduced total cholesterol by 0·23 mmol / l (CI: − 0·37 to − 0·10), especially in men with lower baseline T concentrations, with no change in low density lipoprotein (LDL)-cholesterol. A significant reduction of high density lipoprotein (HDL)-cholesterol was found only in studies with higher mean T-values at baseline ( − 0·085 mmol/l, CI: − 0·017 to − 0·003). Sensitivity and meta-regression analysis revealed that the dose / type of T used, in particular the possibility of aromatization, explained the heterogeneity in findings observed on bone density and HDL-cholesterol among studies. Conclusion The present analysis provides an estimate of the average treatment effects of testosterone therapy in middle-aged men. Our findings are sufficiently strong to justify further interventional studies focused on alternative targets of androgenic treatment carrying more stringent clinical implications, in particular the cardiovascular, metabolic and neurological systems. studies linking androgen decline with the frailty of old age, and the ADAM syndrome has not been universally accepted as a true clinical entity. An alternative approach would be to evaluate whether increasing serum testosterone concentration of ageing men to the level found in young adults improves or reverses these symptoms. Despite much recent interest by physicians, the media and the general population, and the publication of several studies examining the effects of testosterone treatment on body composition, 7-25 strength, bone density and metabolism and lipid
Indian Journal of Endocrinology and Metabolism, 2013
Low testosterone levels are associated with an atherogenic lipid profi le and may contribute to the pathogenesis of atherosclerosis. Aims: Our study aimed to investigate the relationship between serum total testosterone (TT) levels and lipid profi le in angiographically confi rmed coronary artery disease (CAD) in men. Settings and Design: This is a case-control hospital-based study at Teaching Hospital, Karapitiya, Galle, Sri Lanka. Materials and Methods: Two hundred and six men, 103 with angiographically proven CAD and 103 healthy men as a control group were studied. The serum levels of TT and lipids were assessed. Statistical Analysis: Data were analyzed using Minitab software (version 15 for Windows). Results: The mean concentrations of lipid parameters of patients and controls were as follows: Serum total cholesterol (TCh), 5.9 ± 2.8 vs. 5.2 ± 1.6 mmol/l (P = 0.022), low-density lipoprotein cholesterol (LDL-Ch), 3.9 ± 1.2 vs. 3.1 ± 0.5 mmol/l (P = 0.001), high-density lipoprotein cholesterol (HDL-Ch), 1.1 ± 0.5 vs. 1.4 ± 0.6 mmol/l (P = 0.001), and TGs, 2.0 ± 1.0 vs. 1.5 ± 0.8 mmol/l (P = 0.001); lipid levels were signifi cantly different between the two groups. The mean levels of TT in the patients and controls were 11.4 ± 2.7 vs. 18.1 ± 7.2 nmol/l (P = 0.001), signifi cantly different. Among CAD patients, a signifi cant positive association was found between testosterone and HDL-Ch (r = 0.623, P = 0.001), whereas a negative association was found with LDL-Ch (r =-0.579, P = 0.001). Conclusions: Low levels of TT in men with CAD that appear together with an atherogenic lipid milieu may be involved in the pathogenesis of CAD. The observed association between testosterone and HDL-Ch suggests a protective effect of the hormone.
Japanese Heart Journal, 1997
Background and Methods. In order to assess the effects of testosterone undecanoate (TU; 120mg/d orally for 2 months) on serum lipid, lipoprotein, and apolipoprotein levels in healthy elderly men, the placebo (PL) controlled study was performed on 37 elderly men, aged between 53 and 89 years. In all subjects venous blood samples were taken after an overnight (10 hours) fast and sera were stored until analysis. Results. In PL group, neither hormonal data nor lipid, lipoprotein, and apolipoprotein levels showed significant changes. After TU supplementation, serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and significant differences were not observed in the serum triglyceride (TG), highdensity lipoprotein cholesterol (HDL-C), and apolipoprotein (apo) A-1 and apo B levels after TU treatment. The mean ratios TC/HDL-C and LDL-C/HDL-C as coronary risk factor criteria decreased significantly in the TU but not in the PL group. No obvious side effect was observed in those who took TU except for reported pyrosis in 2 of 17 elderly men. Conclusions. These data indicate that the increased serum levels of total testosterone (TT) produced by administration of TU, 120mg/d orally for 2 months lead to supressed levels of TC and LDL-C and E2 but not significantly changed levels of TG, HDL-C, apo A-1 and apo B. Thus, we conclude that TU may be an effective drug for protecting coronary heart disease in healthy elderly men with lowered TT and FT levels. It may also have beneficial effects for sexual function and behavior.
Associations of endogenous testosterone and lipid profiles in middle-aged to older Taiwanese men
International Journal of Impotence Research, 2011
The relationship between endogenous plasma testosterone and plasma lipids was assessed among 856 Taiwanese men^40 years old originally recruited for an epidemiological study of testosterone deficiency syndrome. Blood samples were drawn from fasting (n ¼ 562) and non-fasting (n ¼ 294) subjects between 0800 to 1100 hours. With adjustment of age, body mass index and sex hormonebinding globulin, the following results were shown: (i) triglyceride (TG) levels were negatively associated with quartile levels of testosterone, and the magnitudes of associations were greater for postprandial TGs than for fasting TGs; (ii) high-density lipoprotein cholesterol (HDL-C) levels were positively related to quartile levels of testosterone, but the associations became insignificant after further control of TGs; and (iii) the calculated low-density lipoprotein cholesterol (LDL-C) levels were positively associated with quartile levels of testosterone. Similar results were obtained in multivariate linear regression analyses with additional control of hypertension and diabetes. In these Taiwanese men, the favorable association of endogenous plasma testosterone with HDL-C counterbalances the unfavorable association of it with LDL-C, while the net influence of testosterone on plasma lipids for cardiovascular system was still in the beneficial direction due to its negative association with postprandial plasma TG levels.