scholarly journals State of lipid metabolism in patients receiving androgen replacement therapy

2021 ◽  
Vol 37 (5) ◽  
pp. 20-26
Author(s):  
P. S. Popov ◽  
I. A. Kournikova ◽  
V. I. Torshin ◽  
N. N. Malyutina
Keyword(s):  
Cardiovascular Risk ◽  
Lipid Metabolism ◽  
Replacement Therapy ◽  
Negative Impact ◽  
Modern Medicine ◽  
Testosterone Replacement Therapy ◽  
Androgen Deficiency ◽  
Androgen Replacement Therapy ◽  
Individual Adjustment ◽  
Dose Dependent

Objective. To assess the state of lipid metabolism indicators and predict cardiovascular risk in patients with secondary (acquired) hypogonadism on the background of androgen replacement therapy. Testosterone replacement therapy is often used in modern medicine for diagnosed androgen deficiency in patients of any age group. There are quite a lot of publications devoted to diagnosis and treatment, but the effectiveness and safety of any therapy is determined by several factors, of which two were considered in the presented study dose-dependent effect and compliance. Material and methods. Sixty two patients aged 30 to 52 years with androgen deficiency and a low risk of developing cardiovascular diseases were examined according to the Princeton Consensus criteria. Patients were divided into groups depending on the severity of androgen deficiency and the duration of therapy. Complaints, objective status, muscle strength, daily blood pressure and heart rate monitoring data, lipidogram and sex hormone indicators were evaluated. Results. The obtained data suggest that androgen replacement therapy in doses that lead to an increase in the level of testosterone in the blood above the upper limit of reference values had a negative impact on the lipid spectrum and increased cardiovascular risk for this group of patients. Conclusions. The analyzed approach to therapy of androgen deficiency should provide an individual adjustment of dosage on the background of determining the target blood testosterone level.

scholarly journals Opioid-Induced Androgen Deficiency (OPIAD)

2012 ◽  
Vol 3S;15 (3S;7) ◽  
pp. ES145-ES156
Author(s):  
Jennifer A. Elliott
Keyword(s):  
Replacement Therapy ◽  
Negative Impact ◽  
Hot Flashes ◽  
Opioid Therapy ◽  
Term Treatment ◽  
Laboratory Evaluation ◽  
Androgen Deficiency ◽  
Androgen Replacement Therapy ◽  
Long Term Treatment

Opioid therapy is one of the most effective forms of analgesia currently in use. In the past few decades, the use of opioids as a long-term treatment for chronic pain has increased dramatically. Accompanying this upsurge in the use of long-term opioid therapy has been an increase in the occurrence of opioid associated endocrinopathy, most commonly manifested as an androgen deficiency and therefore referred to as opioid associated androgen deficiency (OPIAD). This syndrome is characterized by the presence of inappropriately low levels of gonadotropins (follicle stimulating hormone and luteinizing hormone) leading to inadequate production of sex hormones, particularly testosterone. Symptoms that may manifest in patients with OPIAD include reduced libido, erectile dysfunction, fatigue, hot flashes, and depression. Physical findings may include reduced facial and body hair, anemia, decreased muscle mass, weight gain, and osteopenia or osteoporosis. Additionally, both men and women with OPIAD may suffer from infertility. While the literature regarding OPIAD remains limited, it is apparent that OPIAD is becoming increasingly prevalent among chronic opioid consumers but often goes unrecognized. OPIAD can have a significant negative impact on the the quality of life of opioid users, and clinicians should anticipate the potential for its occurrence whenever long-term opioid prescribing is undertaken. Once diagnosed, treatment for OPIAD may be offered utilizing a number of androgen replacement therapy options including a variety of testosterone preparations and, for female patients with OPIAD, dehydroepiandrosterone (DHEA) supplementation. Follow-up evaluation of patients receiving androgen replacement therapy should include a review of any unresolved symptoms of hypogonadism, laboratory evaluation, and surveillance for potential adverse effects of androgen replacement therapy including prostate disease in males. Key words: Opioid, hypogonadism, testosterone, endocrine, androgen

scholarly journals Androgen-replacement therapy depresses the ex vivo production of inflammatory cytokines by circulating antigen-presenting cells in aging type-2 diabetic men with partial androgen deficiency

2006 ◽  
Vol 189 (3) ◽  
pp. 595-604 ◽  
Author(s):  
J J Corrales ◽  
M Almeida ◽  
R Burgo ◽  
M T Mories ◽  
J M Miralles ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Inflammatory Cytokines ◽  
Ex Vivo ◽  
Antigen Presenting Cells ◽  
Testosterone Replacement Therapy ◽  
Androgen Deficiency ◽  
Androgen Replacement Therapy ◽  
Antigen Presenting ◽  
Type 2 Diabetic

Androgens are considered to have immunomodulatory effects but their cellular mechanisms of action remain largely unknown. In the present study we prospectively analyzed the serial effects of androgen-replacement therapy on both the distribution of peripheral blood lymphocytes, monocytes and dendritic cells as well as on the production of interleukin (IL)-1β, IL-6 and tumor necrosis factor α (TNFα) inflammatory cytokines by circulating monocytes and CD33 myeloid, CD16 and plasmacytoid dendritic cell subsets, the most potent antigen-presenting cells (APCs) in type-2 diabetic men with partial androgen deficiency. Analyses were performed before therapy and at 1, 3, 6 and 12 months after treatment with 150 mg testosterone enanthate every 2 weeks in a group of 13 type-2 diabetic men. Our results show for the first time that testosterone-replacement therapy is associated with a reduction or complete abrogation of spontaneous ex vivo production of IL-1β, IL-6 and TNFα by APCs. Meanwhile, the in vitro production of inflammatory cytokines by these cells after stimulation with lipopolysaccharide plus recombinant human interferon-γ remained unchanged, suggesting that APCs preserve their constitutive machinery to produce inflammatory cytokines under androgen treatment. These results confirm and extend previous observations about the anti-inflammatory effects of androgen therapy on APCs in a new, previously unexplored model of androgen deficiency; namely, aging type-2 diabetic men. A decreased production of inflammatory cytokines by APCs might have important consequences for sex differences in susceptibility to autoimmune diseases, inflammatory response to injury and atheromatosis.

Correction of Androgen Deficiency in Men with Type 2 Diabetes

2021 ◽  
Vol 16 ◽  
Author(s):  
Volodymyr Pankiv ◽  
Tetyana Yuzvenko ◽  
Nazarii Kobyliak ◽  
Ivan Pankiv
Keyword(s):  
Type 2 Diabetes ◽  
Replacement Therapy ◽  
Testosterone Replacement ◽  
Control Group ◽  
Total Testosterone ◽  
Testosterone Replacement Therapy ◽  
Androgen Deficiency ◽  
Testosterone Undecanoate ◽  
Testosterone Levels

Background: In men with low levels of testosterone in the blood, it is believed that the symptoms can be regarded as an association between testosterone deficiency syndrome and related comorbidities. Aim: to investigate the effectiveness of testosterone therapy in patients with type 2 diabetes (T2D) and androgen deficiency. Materials and methods: Testosterone replacement therapy was carried out in 26 men with T2D and clinically or laboratory-confirmed androgen deficiency. The age of the subjects ranged from 35 to 69 years old. Laboratory studies included determinations of the concentration of the hormones estradiol, luteinizing hormone (LH), and prostate-specific antigen (PSA). The observation period was 9 months. Results: The average level of total blood testosterone in the subjects before treatment was 9.4 mol/l and was likely lower than that of the control group (19.3 ± 1.6 nmol/l). The levels of total testosterone in the subjects ranged from 3.9 nmol/l to 10.7 nmol/l, and hormone levels measuring less than 8.0 nmol/l were observed in only 11 patients. After a course of testosterone replacement therapy, a stabilization in total testosterone levels at the level of reference values (as compared to the start of treatment) was observed in the blood of men with T2D after 9 months of observation and the administration of the fourth injection (16.83 ± 0.75 nmol/l). Conclusion: The use of long-acting injectable testosterone undecanoate leads to normalization of total testosterone levels in the blood of men with T2D and androgen deficiency, and LH levels in these patients are unlikely to change.

scholarly journals Late‐onset hypogonadism: Reductio ad absurdum of the cardiovascular risk‐benefit of testosterone replacement therapy

Andrology ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. 1614-1627 ◽  
Author(s):  
Franz Sesti ◽  
Riccardo Pofi ◽  
Marianna Minnetti ◽  
Marta Tenuta ◽  
Daniele Gianfrilli ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Replacement Therapy ◽  
Late Onset ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Reductio Ad Absurdum ◽  
Late Onset Hypogonadism

scholarly journals Benefits and Consequences of Testosterone Replacement Therapy: A Review

2010 ◽  
Vol 9 (1) ◽  
pp. 59
Author(s):  
Polackwich AS ◽  
Tadros NN ◽  
Ostrowski KA ◽  
◽  
◽  
...  
Keyword(s):  
Mental Health ◽  
Cardiovascular Risk ◽  
Adverse Effects ◽  
Replacement Therapy ◽  
Bone Health ◽  
Late Onset ◽  
Testosterone Replacement ◽  
Testosterone Replacement Therapy ◽  
Late Onset Hypogonadism

Late onset hypogonadism (LOH) is an issue of increasing concern. Studies have shown the importance of testosterone in the maintenance of homeostasis, especially with respect to bone health, sexual function, diabetes, cardiovascular risk, mental health and cognition. Much of the dysfunction in hypogonadism can be reversed or improved with testosterone replacement therapy (TRT). Physicians worry about the possible consequences of TRT, especially regarding the prostate. By reviewing the literature, we have found there are significant benefits to TRT, and fears of adverse effects on the prostate are largely unfounded, though there is a great need for larger studies with longer periods of follow-up, especially to evaluate adverse events.

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