Population differences in the testosterone levels of young men are associated with prostate cancer disparities in older men

2010 ◽  
Vol 22 (4) ◽  
pp. 449-455 ◽  
Author(s):  
Louis Calistro Alvarado
2010 ◽  
Vol 77 (5) ◽  
pp. 1315-1321 ◽  
Author(s):  
Ryan J. Burri ◽  
Alice Y. Ho ◽  
Kevin Forsythe ◽  
Jamie A. Cesaretti ◽  
Nelson N. Stone ◽  
...  
Keyword(s):  

2006 ◽  
Vol 91 (11) ◽  
pp. 4669-4675 ◽  
Author(s):  
Andrea D. Coviello ◽  
Kishore Lakshman ◽  
Norman A. Mazer ◽  
Shalender Bhasin

Abstract Background: Recently we found that testosterone levels are higher in older men than young men receiving exogenous testosterone. We hypothesized that older men have lower apparent testosterone metabolic clearance rates (aMCR-T) that contribute to higher testosterone levels. Objective: The objective of the study was to compare aMCR-T in older and young men and identify predictors of aMCR-T. Methods: Sixty-one younger (19–35 yr) and 60 older (59–75 yr) men were given a monthly GnRH agonist and weekly testosterone enanthate (TE) (25, 50, 125, 300, or 600 mg) for 5 months. Estimated aMCR-T was calculated from the amount of TE delivered weekly and trough serum testosterone concentrations, corrected for real-time absorption kinetics from the im testosterone depot. Results: Older men had lower total (316 ± 13 vs. 585 ± 26 ng/dl, P < 0.00001) and free testosterone (4 ± 0.1 vs. 6 ± 0.3 ng/dl, P < 0.00001) and higher SHBG (52 ± 3 vs. 33 ± 2 nmol/liter, P < 0.00001) than younger men at baseline. Total and free testosterones increased with TE dose and were higher in older men than young men in the 125-, 300-, and 600-mg dose groups. aMCR-T was lower in older men than young men (1390 ± 69 vs. 1821 ± 102 liter/d, P = 0.006). aMCR-T correlated negatively with age (P = 0.0007), SHBG (P = 0.046), and total testosterone during treatment (P = 0.02) and percent body fat at baseline (P = 0.01) and during treatment (P = 0.004). aMCR-T correlated positively with lean body mass at baseline (P = 0.03) and during treatment (P = 0.01). In multiple regression models, significant predictors of aMCR-T included lean body mass (P = 0.008), percent fat mass (P = 0.009), and SHBG (P = 0.001). Conclusions: Higher testosterone levels in older men receiving TE were associated with an age-related decrease in apparent testosterone metabolic clearance rates. Body composition and SHBG were significant predictors of aMCR-T.


2019 ◽  
Vol 104 (12) ◽  
pp. 6238-6246 ◽  
Author(s):  
Glenn R Cunningham ◽  
Susan S Ellenberg ◽  
Shalender Bhasin ◽  
Alvin M Matsumoto ◽  
J Kellogg Parsons ◽  
...  

Abstract Context Prostate-specific antigen (PSA) changes during testosterone treatment of older hypogonadal men have not been rigorously evaluated. Design Double-blinded, placebo-controlled trial. Setting Twelve US academic medical centers. Participants Seven hundred ninety hypogonadal men ≥65 years of age with average testosterone levels ≤275 ng/dL. Men at high risk for prostate cancer were excluded. Interventions Testosterone or placebo gel for 12 months. Main Outcomes Percentile changes in PSA during testosterone treatment of 12 months. Results Testosterone treatment that increased testosterone levels from 232 ± 63 ng/dL to midnormal was associated with a small but substantially greater increase (P < 0.001) in PSA levels than placebo treatment. Serum PSA levels increased from 1.14 ± 0.86 ng/mL (mean ± SD) at baseline by 0.47 ± 1.1 ng/mL at 12 months in the testosterone group and from 1.25 ± 0.86 ng/mL by 0.06 ± 0.72 ng/mL in the placebo group. Five percent of men treated with testosterone had an increase ≥1.7 ng/mL and 2.5% of men had an increase of ≥3.4 ng/mL. A confirmed absolute PSA >4.0 ng/mL at 12 months was observed in 1.9% of men in the testosterone group and 0.3% in the placebo group. Four men were diagnosed with prostate cancer; two were Gleason 8. Conclusions When hypogonadal older men with normal baseline PSA are treated with testosterone, 5% had an increase in PSA ≥1.7 ng/mL, and 2.5% had an increase ≥3.4 ng/mL.


2013 ◽  
Vol 22 (04) ◽  
pp. 260-266 ◽  
Author(s):  
S. P. Tuck ◽  
R. M. Francis ◽  
B. C. Hanusch

SummaryMale osteoporosis is common and results in considerable morbidity and mortality. There are distinct differences in the normal aging of bone between the genders, which result in a lower fracture rate in men. Men who suffer from osteoporosis are much more likely than women to have secondary causes. The identification and treatment of these secondary causes, wherever possible, will result in substantial improvements in BMD. There is now evidence for use of many of the existing agents to treat osteoporosis in men. In younger hypogonadal men testosterone replacement is worth considering, but in older men especially the over sixties this is less effective and there is an increased risk of adverse cardiovascular and prostatic outcomes. Prostate cancer is an increasingly common cause, which is partially the result of the success of ADT. There is now good evidence for the use of bisphosphonates and denosumab in this group of patients. HIV, whilst not being specific to men, is an increasingly recognised cause of male osteoporosis. The reasons for this are multifactorial and some may well be attributable to the anti-retroviral therapy itself. There is emerging evidence of an increased fracture risk in HIV infected individuals. The bone loss can be prevented by the use of bisphosphonates.


Author(s):  
Daniel E. Lage ◽  
M. Dror Michaelson ◽  
Richard J. Lee ◽  
Joseph A. Greer ◽  
Jennifer S. Temel ◽  
...  

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