TY - JOUR
T1 - The effect of testosterone on cardiovascular biomarkers in the testosterone trials
AU - Mohler, Emile R.
AU - Ellenberg, Susan S.
AU - Lewis, Cora E.
AU - Wenger, Nanette K.
AU - Budoff, Matthew J.
AU - Lewis, Michael R.
AU - Barrett-Connor, Elizabeth
AU - Swerdloff, Ronald S.
AU - Stephens-Shields, Alisa
AU - Bhasin, Shalender
AU - Cauley, Jane A.
AU - Crandall, Jill P.
AU - Cunningham, Glenn R.
AU - Ensrud, Kristine E.
AU - Gill, Thomas M.
AU - Matsumoto, Alvin M.
AU - Molitch, Mark E.
AU - Pahor, Marco
AU - Preston, Peter E.
AU - Hou, Xiaoling
AU - Cifelli, Denise
AU - Snyder, Peter J.
N1 - Publisher Copyright:
Copyright © 2018 Endocrine Society.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Context: Studies of the possible cardiovascular risk of testosterone treatment are inconclusive. Objective: To determine the effect of testosterone treatment on cardiovascular biomarkers in older men with low testosterone. Design: Double-blind, placebo-controlled trial. Setting: Twelve academic medical centers in the United States. Participants: In all, 788 men > 65 years old with an average of two serum testosterone levels ,275 ng/dL who were enrolled in The Testosterone Trials. Intervention: Testosterone gel, the dose adjusted to maintain the testosterone level in the normal range for young men, or placebo gel for 12 months. Main Outcome Measures: Serum markers of cardiovascular risk, including lipids and markers of glucose metabolism, fibrinolysis, inflammation, and myocardial damage. Results: Compared with placebo, testosterone treatment significantly decreased total cholesterol (adjustedmean difference,26.1mg/dL; P < 0.001), high-density lipoprotein cholesterol (adjusted mean difference, 22.0mg/dL; P < 0.001), and low-density lipoprotein cholesterol (adjustedmean difference, 22.3 mg/dL; P = 0.051) from baseline to month 12. Testosterone also slightly but significantly decreased fasting insulin (adjusted mean difference, 21.7 mIU/mL; P = 0.02) and homeostatic model assessment insulin resistance (adjusted mean difference, 20.6; P = 0.03). Testosterone did not change triglycerides, D-dimer, C-reactive protein, interleukin 6, troponin, glucose, or hemoglobin A1c levels more than placebo. Conclusions and Relevance: Testosterone treatment of 1 year in oldermen with lowtestosteronewas associated withsmall reductions in cholesterol and insulin but not with other glucosemarkers,markers of inflammation or fibrinolysis, or troponin. The clinical importance of these findings is unclear and requires a larger trial of clinical outcomes.
AB - Context: Studies of the possible cardiovascular risk of testosterone treatment are inconclusive. Objective: To determine the effect of testosterone treatment on cardiovascular biomarkers in older men with low testosterone. Design: Double-blind, placebo-controlled trial. Setting: Twelve academic medical centers in the United States. Participants: In all, 788 men > 65 years old with an average of two serum testosterone levels ,275 ng/dL who were enrolled in The Testosterone Trials. Intervention: Testosterone gel, the dose adjusted to maintain the testosterone level in the normal range for young men, or placebo gel for 12 months. Main Outcome Measures: Serum markers of cardiovascular risk, including lipids and markers of glucose metabolism, fibrinolysis, inflammation, and myocardial damage. Results: Compared with placebo, testosterone treatment significantly decreased total cholesterol (adjustedmean difference,26.1mg/dL; P < 0.001), high-density lipoprotein cholesterol (adjusted mean difference, 22.0mg/dL; P < 0.001), and low-density lipoprotein cholesterol (adjustedmean difference, 22.3 mg/dL; P = 0.051) from baseline to month 12. Testosterone also slightly but significantly decreased fasting insulin (adjusted mean difference, 21.7 mIU/mL; P = 0.02) and homeostatic model assessment insulin resistance (adjusted mean difference, 20.6; P = 0.03). Testosterone did not change triglycerides, D-dimer, C-reactive protein, interleukin 6, troponin, glucose, or hemoglobin A1c levels more than placebo. Conclusions and Relevance: Testosterone treatment of 1 year in oldermen with lowtestosteronewas associated withsmall reductions in cholesterol and insulin but not with other glucosemarkers,markers of inflammation or fibrinolysis, or troponin. The clinical importance of these findings is unclear and requires a larger trial of clinical outcomes.
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U2 - 10.1210/jc.2017-02243
DO - 10.1210/jc.2017-02243
M3 - Article
C2 - 29253154
AN - SCOPUS:85041897255
SN - 0021-972X
VL - 103
SP - 681
EP - 688
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 2
ER -