Low serum free testosterone level is associated with carotid intima-media thickness in middle-aged Japanese men

Tsujimura, Akira; Yamamoto, Ryohei; Okuda, Hidenobu; Yamamoto, Keisuke; Fukuhara, Shinichiro; Yoshioka, Iwao; Kiuchi, Hiroshi; Takao, Tetsuya; Miyagawa, Yasushi; Nishida, Makoto; Yamauchi–Takihara, Keiko; Moriyama, Toshiki; Nonomura, Norio

doi:10.1507/endocrj.ej12-0060

Cited by 21 publications

(28 citation statements)

References 42 publications

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“…Our findings in community-dwelling men are consistent with several smaller studies of middle-aged men with symptomatic low T concentrations [10], men with Type 2 diabetes [12,26], in overweight and obese glucose tolerant young men [27], and in healthy middle-aged men [28]. These studies showed an inverse association between T [10,12], free T [26,27] and bioavailable T [28] with CIMT.…”

Section: Associations Of Sex Hormones With Carotid Plaquesupporting

confidence: 91%

“…However, these associations between T and preclinical carotid atherosclerosis are not present in men with established premature CAD. Given the heterogeneity of previously studied cohorts, our results using LC-MS in two distinct and carefully phenotyped cohorts of men of comparable age may explain previous inconsistencies in the literature [10][11][12][13][14][15][26][27][28].…”

Section: Associations Of Sex Hormones With Carotid Plaquementioning

confidence: 84%

“…These studies showed an inverse association between T [10,12], free T [26,27] and bioavailable T [28] with CIMT. Of these studies, two did not report on the proportion of men with CVD [26,28] while the rest excluded men with CVD [10,12,27]. In contrast to our findings, a study by van den Beld et al in older men reported inverse associations of T with CIMT which were comparable for men with or without CVD [29].…”

Section: Associations Of Sex Hormones With Carotid Plaquementioning

confidence: 92%

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Testosterone, dihydrotestosterone and estradiol are differentially associated with carotid intima-media thickness and the presence of carotid plaque in men with and without coronary artery disease

et al. 2015

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CIRCULATING TESTOSTERONE (T) is lower in older men compared with younger men, and older men have a higher incidence and prevalence of cardiovascular disease (CVD) [1,2]. In epidemiological studies, lower T concentrations are also associated with a range of adverse health outcomes, including increased risk of CVD and all-cause mortality [3,4]. On the contrary, benefits of T supplementation have not been recipro- Abstract. Clarifying the relationship of sex hormones to preclinical atherosclerosis could illuminate pathways by which androgens are associated with cardiovascular events and mortality. Our aim was to determine hormone profiles associated with carotid intima-media thickness (CIMT) and carotid atheroma, in men with and without known coronary artery disease (CAD). We included 492 community-based men aged 20-70 years (Group A) and 426 men with angiographically proven CAD aged <60 years (Group B). Fasting early morning sera were assayed for testosterone (T), dihydrotestosterone (DHT) and estradiol (E2) using mass spectrometry. CIMT and carotid plaque were assessed ultrasonographically. In community-dwelling men, higher T is associated with favourable CIMT and lower prevalence of carotid plaque, while higher E2 is associated with worse CIMT. In men with CAD, higher DHT or E2 are associated with less carotid plaque. T, DHT and E2 are differentially associated with preclinical carotid atherosclerosis in a cardiovascular phenotype-specific manner. Interventional studies are needed to examine effects of exogenous T and its metabolites DHT and E2, on atherogenesis.

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Section: Associations Of Sex Hormones With Carotid Plaquesupporting

confidence: 91%

Section: Associations Of Sex Hormones With Carotid Plaquementioning

confidence: 84%

Section: Associations Of Sex Hormones With Carotid Plaquementioning

confidence: 92%

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Testosterone, dihydrotestosterone and estradiol are differentially associated with carotid intima-media thickness and the presence of carotid plaque in men with and without coronary artery disease

et al. 2015

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“…Furthermore, LUTS and ED are considered to be risk factors for cardiovascular disease (CVD) based on several previous studies. Because we already reported that a lower level of serum testosterone level was associated with a higher carotid artery intima-media thickness in middle-aged Japanese men, 3 LOH might also be related with CVD caused by the progression of atherosclerosis. Atherosclerosis is a systematic disease in which plaque builds up inside the arteries that can lead to serious problems relating to QOL.…”

Section: Introductionmentioning

confidence: 94%

Atherosclerosis is associated with erectile function and lower urinary tract symptoms, especially nocturia, in middle-aged men

Tsujimura

Hiramatsu

Aoki

et al. 2017

Prostate International

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BackgroundAtherosclerosis is a systematic disease in which plaque builds up inside the arteries that can lead to serious problems related to quality of life (QOL). Lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and late-onset hypogonadism (LOH) are highly prevalent in aging men and are significantly associated with a reduced QOL. However, few questionnaire-based studies have fully examined the relation between atherosclerosis and several urological symptoms.Materials and methodsThe study comprised 303 outpatients who visited our clinic with symptoms of LOH. Several factors influencing atherosclerosis, including serum concentrations of triglyceride, fasting blood sugar, and total testosterone measured by radioimmunoassay, were investigated. We also measured brachial-ankle pulse wave velocity (baPWV) and assessed symptoms by specific questionnaires, including the Sexual Health Inventory for Men (SHIM), Erection Hardness Score (EHS), International Prostate Symptom Score (IPSS), QOL index, and Aging Male Symptoms rating scale (AMS). Stepwise associations between the ratio of measured/age standard baPWV and clinical factors including laboratory data and the scores of the questionnaires were compared using the Jonckheere–Terpstra test for trend. The associations between the ratio of measured/age standard baPWV and each IPSS score were assessed in a multivariate linear regression model after adjustment for serum triglyceride, fasting blood sugar, and total testosterone.ResultsRegarding ED, a higher level of the ratio of measured/age standard baPWV was associated with a lower EHS, whereas no association was found with SHIM. Regarding LUTS, a higher ratio of measured/age standard baPWV was associated with a higher IPSS and QOL index. However, there was no statistically significant difference between the ratio of measured/age standard baPWV and AMS. A multivariate linear regression model showed only nocturia to be associated with the ratio of measured/age standard baPWV for each IPSS score.ConclusionAtherosclerosis is associated with erectile function and LUTS, especially nocturia.

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“…All 10 documented an inverse relationship with TT, free T, or bioavailable T (Table 5). [120][121][122][123][124][125][126][127][128][129] None has reported a significant relationship between higher T and increased carotid intima-media thickness. Hak et al 163 investigated 1032 men in the Rotterdam Continued on next page study and found an inverse relationship between serum T and atherosclerosis of the abdominal aorta.…”

Section: Testosterone Carotid Intima-media Thickness and Atherosclementioning

confidence: 99%

Testosterone Therapy and Cardiovascular Risk: Advances and Controversies

Morgentaler

Miner

Caliber

et al. 2015

Mayo Clinic Proceedings

180

171

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Two recent studies raised new concerns regarding cardiovascular (CV) risks with testosterone (T) therapy. This article reviews those studies as well as the extensive literature on T and CV risks. A MEDLINE search was performed for the years 1940 to August 2014 using the following key words: testosterone, androgens, human, male, cardiovascular, stroke, cerebrovascular accident, myocardial infarction, heart attack, death, and mortality. The weight and direction of evidence was evaluated and level of evidence (LOE) assigned. Only 4 articles were identified that suggested increased CV risks with T prescriptions: 2 retrospective analyses with serious methodological limitations, 1 placebo-controlled trial with few major adverse cardiac events, and 1 meta-analysis that included questionable studies and events. In contrast, several dozen studies have reported a beneficial effect of normal T levels on CV risks and mortality. Mortality and incident coronary artery disease are inversely associated with serum T concentrations (LOE IIa), as is severity of coronary artery disease (LOE IIa). Testosterone therapy is associated with reduced obesity, fat mass, and waist circumference (LOE Ib) and also improves glycemic control (LOE IIa). Mortality was reduced with T therapy in 2 retrospective studies. Several RCTs in men with coronary artery disease or heart failure reported improved function in men who received T compared with placebo. The largest meta-analysis to date revealed no increase in CV risks in men who received T and reduced CV risk among those with metabolic disease. In summary, there is no convincing evidence of increased CV risks with T therapy. On the contrary, there appears to be a strong beneficial relationship between normal T and CV health that has not yet been widely appreciated.

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Low serum free testosterone level is associated with carotid intima-media thickness in middle-aged Japanese men

Cited by 21 publications

References 42 publications

Testosterone, dihydrotestosterone and estradiol are differentially associated with carotid intima-media thickness and the presence of carotid plaque in men with and without coronary artery disease

Testosterone, dihydrotestosterone and estradiol are differentially associated with carotid intima-media thickness and the presence of carotid plaque in men with and without coronary artery disease

Atherosclerosis is associated with erectile function and lower urinary tract symptoms, especially nocturia, in middle-aged men

Testosterone Therapy and Cardiovascular Risk: Advances and Controversies

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