Preoperative Supraphysiological Testosterone in Older Men Undergoing Knee Replacement Surgery

Amory, John K.; Chansky, Howard A.; Chansky, Kari; Camuso, Matthew R.; Hoey, Chris T.; Anawalt, Bradley D.; Matsumoto, Alvin M.; Bremner, William J.

doi:10.1046/j.1532-5415.2002.50462.x

Cited by 69 publications

(59 citation statements)

References 17 publications

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“…Twelve men were recruited in succession from a total of 36 men that met entry criteria for randomization to T or placebo administration before knee or hip replacement at the DVA-PSHCS, as described previously (1). Inclusion criteria included male sex, age Ͼ55 yr, and a decision by the patient and an orthopedic surgeon to undergo elective hip or knee replacement.…”

Section: Participantsmentioning

confidence: 99%

“…All male patients at the DVA-PSHCS, Seattle Division, undergoing elective unilateral hip or knee replacement over a 2-yr period were offered enrollment in the original study (1). After informed consent was obtained, recruitment for the present study began at enrollment of the 21st subject until 12 subjects were randomized into treatment (n ϭ 6) and placebo (n ϭ 6) groups by the study pharmacist using a random number sequence.…”

Section: Randomizationmentioning

confidence: 99%

“…Recently, intramuscular T in supraphysiological dosages has been administered to men to evaluate T effects on body composition and metabolism (10,29) and to determine whether T could decrease length of hospital stay after knee or hip replacement (1). In the present study, we examined the effect on lipids of supraphysiological T administration (600 mg/wk im) to eugonadal, obese, elderly men.…”

mentioning

confidence: 99%

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Testosterone administration to men increases hepatic lipase activity and decreases HDL and LDL size in 3 wk

Herbst¹,

Amory²,

Brunzell³

et al. 2003

American Journal of Physiology-Endocrinology and Metabolism

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. Testosterone administration to men increases hepatic lipase activity and decreases HDL and LDL size in 3 wk. Am J Physiol Endocrinol Metab 284: E1112-E1118, 2003; 10.1152/ ajpendo.00524.2002.-Testosterone administration to men is known to decrease high-density lipoprotein cholesterol (HDL-C) and the subclasses HDL 2 and HDL3. It also might increase the number of small, dense, low-density lipoprotein cholesterol (LDL-C) particles in hypogonadal men. The decrease in HDL-C and in LDL-C size is potentially mediated by hepatic lipase activity, which hydrolyzes lipoprotein phospholipids and triacylglycerol. To determine how HDL-C and LDL-C particles are affected by testosterone administration to eugonadal men, testosterone was administered as a supraphysiological dose (600 mg/wk) for 3 wk to elderly, obese, eugonadal men before elective hip or knee surgery, and lipids were measured by routine methods and by density gradient ultracentrifugation. Hepatic lipase activity increased Ͼ60% above baseline levels, and HDL-C, HDL 2, and HDL3 significantly declined in 3 wk. In addition, the LDL-C peak particle density and the amount of LDL-C significantly increased. Testosterone is therefore a potent stimulator of hepatic lipase activity, decreasing HDL-C, HDL 2, and HDL3 as well as increasing LDL particle density changes, all associated with increased cardiovascular risk.androgen; lipoprotein particle density TESTOSTERONE (T) administration to men is known to decrease HDL-cholesterol (HDL-C) (6-8, 25, 39), although not necessarily in hypogonadal men (27,30,42). When HDL-C declines with T administration in both eugonadal and hypogonadal men, it is unclear whether this decrease is in the subclasses HDL 2 (22) or HDL 3 (32-34) or both. That HDL-C decreases with T administration might be important for long-term use of T in men, because low HDL-C, including low HDL 2 and low HDL 3 , is associated with an increased risk for cardiovascular disease (3,14,26).The decrease in HDL-C with T administration is likely mediated by an increase in hepatic lipase (HL) activity. Consistent with this is the fact that HL activity is higher overall in men than in women (4) and is higher with central obesity (11,12). HL is produced primarily by the liver and is located on the luminal surface of sinusoidal endothelial cells. It catalyzes the hydrolysis of triacylglycerols and phospholipids, mediating the removal of lipoproteins from plasma (23). This hydrolysis converts the more buoyant HDL 2 to the smaller, denser HDL 3 , which can be taken up by the liver, thereby decreasing HDL-C. In addition, HL by the same mechanism converts large, buoyant LDL to small, dense LDL (41), the latter also being a risk factor for cardiovascular disease (2,24,31). One study demonstrated an increase in one population of small, dense LDL particles with T administration to hypogonadal men (32), but a cross-sectional study demonstrated an inverse association between serum T levels and small, dense LDL (29), although the T levels in that study have been called into questi...

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Section: Participantsmentioning

confidence: 99%

Section: Randomizationmentioning

confidence: 99%

mentioning

confidence: 99%

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Testosterone administration to men increases hepatic lipase activity and decreases HDL and LDL size in 3 wk

Herbst¹,

Amory²,

Brunzell³

et al. 2003

American Journal of Physiology-Endocrinology and Metabolism

Self Cite

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“…Testosterone administration to hypogonadal older males increased muscle strength [33,34], and in persons who are borderline hypogonadal it increased muscle mass [35]. Two small studies have suggested an improvement in function after testosterone administration [36,37]. The effects of testosterone on muscle are listed in Table II.…”

Section: Sarcopenia Cytokines and Hormonesmentioning

confidence: 97%

Frailty and the aging male

et al. 2005

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Frailty occurs in aging males for a variety of reasons. It is less common in males than females. Diseases which are particularly associated with frailty are diabetes mellitus, atherosclerosis, anemia and chronic obstructive pulmonary disease. Insulin resistance syndrome plays a pathogenetic role in the "fat-frail" syndrome. Sarcopenia occurs predominantly because of hormone deficiency and cytokine excess. Pain and anorexia are also associated with frailty. Stem cell research represents a potential promise for the treatment of frailty.

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“…Testosterone replacement in patients following hospitalization has resulted in improvement in function [22,23].…”

Section: Hormones and Frailty Testosteronementioning

confidence: 99%

Frailty and Hormones

Morley

Kim

Haren

2005

Rev Endocr Metab Disord

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Preoperative Supraphysiological Testosterone in Older Men Undergoing Knee Replacement Surgery

Cited by 69 publications

References 17 publications

Testosterone administration to men increases hepatic lipase activity and decreases HDL and LDL size in 3 wk

Testosterone administration to men increases hepatic lipase activity and decreases HDL and LDL size in 3 wk

Frailty and the aging male

Frailty and Hormones

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