Impact of testosterone treatment on postprandial triglyceride metabolism in elderly men with subnormal testosterone levels

SummaryMen have a higher incidence of cardiovascular disease (CVD) than women of similar age, and it has been suggested that testosterone may influence the development of CVD. Recently, we demonstrated that elderly men with low testosterone levels had lower plasma levels of free tissue factor pathway inhibitor (TFPI) Ag associated with shortened tissue factor (TF)-induced coagulation initiation in a population based case-control study. Our hypothesis was that one year of testosterone treatment to physiological levels in elderly men would increase the levels of free TFPI Ag in plasma and have a favorable effect on TF-induced coagulation. Twenty-six men with low testosterone levels (≤11.0 nM) were randomly assigned to treatment with intramuscular testosterone depot injections (testosterone undecanoate 1,000 mg) or placebo in a double-blinded study. Each participant received a total of five injections, at baseline, 6, 16, 28 and 40 weeks, and TF-induced thrombin generation ex vivo and plasma free TFPI Ag were measured after one year. At the end of the study total and free testosterone levels were significantly higher in the testosterone treated group (14.9 ± 4.5 nM vs. 8.1 ± 2.4 nM; p<0.001, and 363.3 ± 106.6 pM vs. 187.3 ± 63.2 pM; p<0.001, respectively). Testosterone treatment for one year did neither cause significant changes in TF-induced thrombin generation ex vivo nor changes in plasma levels of free TFPI Ag. In conclusion, normalising testosterone levels by testosterone treatment for 12 months in elderly men did not affect TF-induced coagulation or plasma TFPI levels. The potential antithrombotic role of testosterone therapy remains to be elucidated.

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Beneficial effects of 2 years of administration of parenteral testosterone undecanoate on the metabolic syndrome and on non-alcoholic liver steatosis and C-reactive protein

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci.2010.002 ◽

2010 ◽

Vol 1 (1) ◽

Cited By ~ 1

Author(s):

Ahmad Haider ◽

Louis J.G. Gooren ◽

Pawin Padungtod ◽

Farid Saad

Keyword(s):

Metabolic Syndrome ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

C Reactive Protein ◽

Elderly Men ◽

Testosterone Undecanoate ◽

Testosterone Treatment ◽

Testosterone Levels ◽

Reactive Protein ◽

The Metabolic Syndrome

Abstract: Elderly men often show a concurrence of a decline of testosterone with attributes of the metabolic syndrome. This study tested the effects of normalization of testosterone.: A total of 122 hypogonadal men (18–83 years, mean 59.6±8.0 years; n=11<45 years, n=25<55 years, n=53<65 years) were included in the study. Their baseline testosterone levels were between 0.14 and 4.51 ng/mL (n>4.90 ng/mL) and were treated with parenteral testosterone undecanoate for 2 years as the sole intervention (administration at 0 and 6 weeks, and thereafter every 12 weeks).: Plasma testosterone increased from 3.3±1.9 ng/mL to 4.1±1.5 ng/mL (p<0.01) at 3 months, and then stabilized at 6.8±1.3 ng/mL after the first 6 months. There was a remarkable progressive linear decline in body weight, body mass index, and waist circumference over the entire study period. Plasma cholesterol decreased significantly over the first 12 months, and then stabilized. Plasma glucose, triglycerides, low-density lipoprotein cholesterol, and C-reactive protein decreased significantly and high-density lipoprotein cholesterol increased significantly over the 24-month study period in a non-linear manner. There was a significant decrease in aspartate aminotransferase and alanine aminotransferase levels over the first 9 and 12 months, and then values leveled off. Changes in variables were largely correlated with changes in testosterone levels. At baseline, 47 out of 122 subjects fulfilled the metabolic syndrome criteria as defined by the National Cholesterol Education Program (2001); after 2 years of testosterone treatment, this number had declined to 11 out of 122 subjects.: With testosterone treatment over 2 years, the most significant improvement of the metabolic syndrome was noted over the first 12 months, but over the following 12 months further improvement was also observed. With regard to safety of testosterone administration to mainly elderly men, a number of safety measures were carried out.

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Testosterone treatment in elderly men with subnormal testosterone levels improves body composition and BMD in the hip

International Journal of Impotence Research ◽

10.1038/ijir.2008.19 ◽

2008 ◽

Vol 20 (4) ◽

pp. 378-387 ◽

Cited By ~ 96

Author(s):

J Svartberg ◽

I Agledahl ◽

Y Figenschau ◽

T Sildnes ◽

K Waterloo ◽

...

Keyword(s):

Body Composition ◽

Elderly Men ◽

Testosterone Treatment ◽

Testosterone Levels

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The Effects of Testosterone on Cognition in Elderly Men: A Review

CNS Spectrums ◽

10.1017/s1092852900016990 ◽

2008 ◽

Vol 13 (10) ◽

pp. 887-897 ◽

Cited By ~ 16

Author(s):

Matthew F. Warren ◽

Michael J. Serby ◽

David M. Roane

Keyword(s):

Cognitive Measures ◽

Elderly Men ◽

Cognitive Domains ◽

Testosterone Levels ◽

Visuospatial Function ◽

Androgen Depletion ◽

The Relationship ◽

With Memory ◽

Larger Sample

ABSTRACTIn this article, the literature examining the relationship between testosterone and various cognitive domains in elderly men is reviewed. The review focuses on the role of endogenous testosterone levels and the effects of androgen depletion and replacement. The cognitive domains most commonly linked to testosterone include memory and visuospatial function. Indeed, the literature suggests that in certain conditions (ie, hypogonadism, cognitive impairment) testosterone levels may be significantly associated with memory and visuospatial function, but not other cognitive functions. Studies with larger sample sizes and more sensitive cognitive measures are indicated, as questions remain about the potential role of testosterone as a cognitive enhancer.

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Testosterone Treatment Is Associated with Reduced Mortality in Men with Low Serum Testosterone Levels

10.1210/endo-meetings.2011.part2.p20.p1-772 ◽

2011 ◽

pp. P1-772-P1-772

Author(s):

Molly M Shores ◽

Nicholas L Smith ◽

Christopher W Forsberg ◽

Bradley D Anawalt ◽

Alvin M Matsumoto

Keyword(s):

Serum Testosterone ◽

Testosterone Treatment ◽

Testosterone Levels ◽

Low Serum

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P3479Mediterranean type of diet and olive oil consumption show beneficial effects on sexual capacity through improvement of aortic elastic properties and testosterone levels in elderly men from IKARIA stud

European Heart Journal ◽

10.1093/eurheartj/ehy563.p3479 ◽

2018 ◽

Vol 39 (suppl_1) ◽

Author(s):

C Chrysohoou ◽

J Skoumas ◽

G Lazaros ◽

M Zaromytidou ◽

C Masoura ◽

...

Keyword(s):

Olive Oil ◽

Elastic Properties ◽

Oil Consumption ◽

Elderly Men ◽

Testosterone Levels ◽

Beneficial Effects ◽

Aortic Elastic Properties

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Plasma free tissue factor pathway inhibitor (TFPI) levels and TF-induced thrombin generation ex vivo in men with low testosterone levels

Thrombosis and Haemostasis ◽

10.1160/th08-10-0667 ◽

2009 ◽

Vol 101 (03) ◽

pp. 471-477 ◽

Cited By ~ 7

Author(s):

Ingvild Agledahl ◽

Johan Svartberg ◽

Bjarne Hansen ◽

Ellen Brodin

Keyword(s):

Tissue Factor ◽

Thrombin Generation ◽

Tissue Factor Pathway Inhibitor ◽

Ex Vivo ◽

Elderly Men ◽

Lower Plasma ◽

Testosterone Levels ◽

Initiation Phase ◽

Tissue Factor Pathway ◽

Low Testosterone

SummaryLow testosterone levels in men have been associated with cardiovascular risk factors, some prothrombotic factors, and lately also an increased risk of both cardiovascular disease and all-cause mortality. Experimental studies have shown increased synthesis and release of tissue factor pathway inhibitor (TFPI) by physiological levels of testosterone in endothelial cells. Our hypothesis was that elderly men with low testosterone levels would have lower plasma levels of plasma free TFPI with subsequent increased thrombin generation. Elderly men with low (n=37) and normal (n=41) testosterone levels were recruited from a general population, and tissue factor (TF)-induced thrombin generation ex vivo and plasma free TFPI Ag were measured. Elderly men with low testosterone levels had lower plasma free TFPI Ag (10.9 ± 2.3 ng/ml vs. 12.3 ± 3.0 ng/ml, p=0.027) and shorter initiation phase of TF-induced coagulation assessed by lag-time (5.1 ± 1.0 min vs. 5.7 ± 1.3, p=0.039). The differences between groups remained significant and were strengthened after adjustment for waist circumference and other cardiovascular risk factors. Lag-time increased linearly across quartiles of plasma free TFPI Ag (p<0.001). Multiple regression analysis revealed that total and free testosterone were independent predictors of plasma free TFPI Ag. Our findings suggest that low testosterone levels in elderly men is associated with low plasma free TFPI Ag and subsequent shortened initiation phase of TF-induced coagulation.

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Endogenous Testosterone Levels and the Risk of Incident Cardiovascular Events in Elderly Men: The MrOS Prospective Study

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa038 ◽

2020 ◽

Vol 4 (5) ◽

Author(s):

Tinh-Hai Collet ◽

Susan K Ewing ◽

Kristine E Ensrud ◽

Gail A Laughlin ◽

Andrew R Hoffman ◽

...

Keyword(s):

Prospective Study ◽

Sex Hormones ◽

Community Dwelling ◽

Sex Hormone Binding Globulin ◽

Total Testosterone ◽

Continuous Variables ◽

Elderly Men ◽

Sleep Study ◽

Testosterone Levels ◽

Increased Risk

Abstract Context Observational studies show discordant links between endogenous testosterone levels and cardiovascular diseases (CVD). Objective We assessed whether sex hormones and sex hormone–binding globulin (SHBG) are associated with CVD in community-dwelling elderly men. Design, Setting and Participants Prospective study of incident CVD among 552 men ≥ 65 years in the MrOS Sleep Study without prevalent CVD and no testosterone therapy at baseline. Outcomes Fasting serum levels of total testosterone and estradiol were measured using liquid chromatography-mass spectrometry, and SHBG by chemiluminescent substrate. The association of sex hormones and SHBG with incident coronary heart disease (CHD), cerebrovascular (stroke and transient ischemic attack) and peripheral arterial disease (PAD) events were assessed by quartile and per SD increase in proportional hazards models. Results After 7.4 years, 137 men (24.8%) had at least 1 CVD event: 90 CHD, 45 cerebrovascular and 26 PAD. The risk of incident CVD events was not associated with quartiles of baseline sex hormones or SHBG (all P ≥ 0.16). For +1 SD in total testosterone, the multivariate-adjusted hazard ratio was 1.04 (95% CI, 0.80-1.34) for CHD, 0.86 (0.60-1.25) for cerebrovascular, and 0.81 (0.52-1.26) for PAD events. When analyzed as continuous variables or comparing highest to low quartile, levels of bioavailable testosterone, total estradiol, testosterone/estradiol ratio and SHBG were not associated with CVD events. Conclusions In community-dwelling elderly men, endogenous levels of testosterone, estradiol, and SHBG were not associated with increased risk of CHD, cerebrovascular, or PAD events. These results are limited by the small number of events and should be explored in future studies.

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