Whether lower testosterone levels are a causal factor or biomarker for disease in older men remains fiercely debated, as randomized controlled trials with endpoints of cardiovascular events or mortality are lacking. H...Whether lower testosterone levels are a causal factor or biomarker for disease in older men remains fiercely debated, as randomized controlled trials with endpoints of cardiovascular events or mortality are lacking. Here, a recent retrospective study in US veterans is discussed, which compares mortality rates in men who were and were not prescribed testosterone.展开更多
As men grow older, circulating testosterone declines while the incidence of cardiovascular disease increases. Thus, the role of sex hormones as biomarkers, and possibly contributing factors to clinical manifestations ...As men grow older, circulating testosterone declines while the incidence of cardiovascular disease increases. Thus, the role of sex hormones as biomarkers, and possibly contributing factors to clinical manifestations of cardiovascular disease in the increasing demographic of aging men, has attracted considerable interest. This review focuses on observational studies of endogenous androgens, namely circulating testosterone and dihydrotestosterone, which have examined their associations with cardiovascular events such as myocardial infarction and stroke. Studies which have examined the associations of endogenous estrogens, namely circulating estradiol, with these outcomes are also discussed. In large prospective cohort studies of predominantly middle-aged and older men, lower circulating testosterone consistently predicts higher incidence of cardiovascular events. Of note, both lower circulating testosterone and lower dihydrotestosterone are associated with higher incidence of stroke. These associations are less apparent when myocardial infarction is considered as the outcome. Results for estradiol are inconsistent. Lower circulating testosterone has been shown to predict higher cardiovascular disease-related mortality, as has lower circulating dihydrotestosterone. It is possible that the relationship of circulating androgens to cardiovascular events or mortality outcomes may be U-shaped rather than linear, with an optimal range defining men at lowest risk. Epidemiological studies are observational in nature and do not prove causality. Associations observed in studies of endogenous androgens need not necessarily translate into similar effects of exogenous androgens. Rigorous randomized controlled trials are needed to clarify the effects of testosterone treatment on cardiovascular risk in men.展开更多
In this issue of Asian Journal of Andrology （AJA）, several experts have reviewed L the latest data on the potential and known effects of endogenous and exogenous testosterone （T） on cardiovascular risk. In the re...In this issue of Asian Journal of Andrology （AJA）, several experts have reviewed L the latest data on the potential and known effects of endogenous and exogenous testosterone （T） on cardiovascular risk. In the review by Meyer and Wittert, low endogenous serum T appears to be associated with higher risk of cardiovascular disease and overall mortality in certain populations such as Klinefelter syndrome and older men,展开更多
Epidemiological studies hint at a beneficial influence of endogenous circulating testosterone （T）, or its metabolite dihydrotestosterone （DHT）, such that men with lower concentrations of T or DHT appear to have po...Epidemiological studies hint at a beneficial influence of endogenous circulating testosterone （T）, or its metabolite dihydrotestosterone （DHT）, such that men with lower concentrations of T or DHT appear to have poorer health outcomes including frailty, diabetes, cardiovascular disease, and mortality.展开更多
文摘Whether lower testosterone levels are a causal factor or biomarker for disease in older men remains fiercely debated, as randomized controlled trials with endpoints of cardiovascular events or mortality are lacking. Here, a recent retrospective study in US veterans is discussed, which compares mortality rates in men who were and were not prescribed testosterone.
文摘As men grow older, circulating testosterone declines while the incidence of cardiovascular disease increases. Thus, the role of sex hormones as biomarkers, and possibly contributing factors to clinical manifestations of cardiovascular disease in the increasing demographic of aging men, has attracted considerable interest. This review focuses on observational studies of endogenous androgens, namely circulating testosterone and dihydrotestosterone, which have examined their associations with cardiovascular events such as myocardial infarction and stroke. Studies which have examined the associations of endogenous estrogens, namely circulating estradiol, with these outcomes are also discussed. In large prospective cohort studies of predominantly middle-aged and older men, lower circulating testosterone consistently predicts higher incidence of cardiovascular events. Of note, both lower circulating testosterone and lower dihydrotestosterone are associated with higher incidence of stroke. These associations are less apparent when myocardial infarction is considered as the outcome. Results for estradiol are inconsistent. Lower circulating testosterone has been shown to predict higher cardiovascular disease-related mortality, as has lower circulating dihydrotestosterone. It is possible that the relationship of circulating androgens to cardiovascular events or mortality outcomes may be U-shaped rather than linear, with an optimal range defining men at lowest risk. Epidemiological studies are observational in nature and do not prove causality. Associations observed in studies of endogenous androgens need not necessarily translate into similar effects of exogenous androgens. Rigorous randomized controlled trials are needed to clarify the effects of testosterone treatment on cardiovascular risk in men.
文摘In this issue of Asian Journal of Andrology （AJA）, several experts have reviewed L the latest data on the potential and known effects of endogenous and exogenous testosterone （T） on cardiovascular risk. In the review by Meyer and Wittert, low endogenous serum T appears to be associated with higher risk of cardiovascular disease and overall mortality in certain populations such as Klinefelter syndrome and older men,
文摘Epidemiological studies hint at a beneficial influence of endogenous circulating testosterone （T）, or its metabolite dihydrotestosterone （DHT）, such that men with lower concentrations of T or DHT appear to have poorer health outcomes including frailty, diabetes, cardiovascular disease, and mortality.
