OBJECTIVE: Because male sex is an independent risk factor for the severity of atherosclerosis, it is possible that androgens may be proatherogenic. There is evidence that sex hormones, particularly estrogens, regulate (or modulate) inflammation, a process integral to atherogenesis. Because levels of serum inflammatory markers predict cardiovascular outcomes, we prospectively assessed the effects of androgen therapy on these markers in older men. METHODS AND RESULTS:Levels of high-sensitivity C-reactive protein (CRP), soluble intracellular adhesion molecule-1 (sICAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured from sera collected at baseline and at the end of 2 randomized double-blind placebo-controlled trials evaluating the effects of 3 months of androgen treatment with either dihydrotestosterone (DHT) or recombinant human chorionic gonadotropin (rhCG) in healthy men aged >60 years with partial androgen deficiency (serum testosterone levels <15 nmol/L). For the DHT study (70 mg transdermally daily), 33 men completed 3 months of treatment (16 men were treated with DHT, and there were 17 controls). For the rhCG (250 microg twice weekly) study, 20 men were treated with rhCG, and there were 20 controls. In both studies, groups were well matched for age and vascular risk factors. Androgen levels (DHT and testosterone) were consistently maintained at eugonadal levels throughout the trials, with estradiol markedly increased by rhCG but not DHT. Baseline CRP levels were 0.74 to 1.49 mg/L, sVCAM-1 levels were 847 to 950 ng/mL, and sICAM-1 levels were 256 to 292 ng/mL in all groups. Neither DHT nor rhCG resulted in significant changes in CRP, sVCAM-1, or sICAM-1 compared with placebo (P>0.3 in both studies). CONCLUSIONS:Exogenous androgen therapy with or without increased estradiol levels does not alter serum inflammatory markers in older men; this finding is in contrast to the effects of estrogens on inflammatory markers that have been found in postmenopausal women. These data provide a measure of reassurance concerning potential adverse cardiovascular effects of androgen therapy in older men.
RCT Entities:
OBJECTIVE: Because male sex is an independent risk factor for the severity of atherosclerosis, it is possible that androgens may be proatherogenic. There is evidence that sex hormones, particularly estrogens, regulate (or modulate) inflammation, a process integral to atherogenesis. Because levels of serum inflammatory markers predict cardiovascular outcomes, we prospectively assessed the effects of androgen therapy on these markers in older men. METHODS AND RESULTS: Levels of high-sensitivity C-reactive protein (CRP), soluble intracellular adhesion molecule-1 (sICAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured from sera collected at baseline and at the end of 2 randomized double-blind placebo-controlled trials evaluating the effects of 3 months of androgen treatment with either dihydrotestosterone (DHT) or recombinant human chorionic gonadotropin (rhCG) in healthy men aged >60 years with partial androgen deficiency (serum testosterone levels <15 nmol/L). For the DHT study (70 mg transdermally daily), 33 men completed 3 months of treatment (16 men were treated with DHT, and there were 17 controls). For the rhCG (250 microg twice weekly) study, 20 men were treated with rhCG, and there were 20 controls. In both studies, groups were well matched for age and vascular risk factors. Androgen levels (DHT and testosterone) were consistently maintained at eugonadal levels throughout the trials, with estradiol markedly increased by rhCG but not DHT. Baseline CRP levels were 0.74 to 1.49 mg/L, sVCAM-1 levels were 847 to 950 ng/mL, and sICAM-1 levels were 256 to 292 ng/mL in all groups. Neither DHT nor rhCG resulted in significant changes in CRP, sVCAM-1, or sICAM-1 compared with placebo (P>0.3 in both studies). CONCLUSIONS: Exogenous androgen therapy with or without increased estradiol levels does not alter serum inflammatory markers in older men; this finding is in contrast to the effects of estrogens on inflammatory markers that have been found in postmenopausal women. These data provide a measure of reassurance concerning potential adverse cardiovascular effects of androgen therapy in older men.
Authors: Jie Jin Wang; Robert J Ross; Jingsheng Tuo; George Burlutsky; Ava G Tan; Chi-Chao Chan; Emmanuel J Favaloro; Andrew Williams; Paul Mitchell Journal: Ophthalmology Date: 2007-08-02 Impact factor: 12.079
Authors: K K Tsilidis; S Rohrmann; K A McGlynn; S J Nyante; D S Lopez; G Bradwin; M Feinleib; C E Joshu; N Kanarek; W G Nelson; E Selvin; E A Platz Journal: Andrology Date: 2013-09-30 Impact factor: 3.842
Authors: Ronald S Swerdloff; Robert E Dudley; Stephanie T Page; Christina Wang; Wael A Salameh Journal: Endocr Rev Date: 2017-06-01 Impact factor: 19.871
Authors: Emile R Mohler; Susan S Ellenberg; Cora E Lewis; Nanette K Wenger; Matthew J Budoff; Michael R Lewis; Elizabeth Barrett-Connor; Ronald S Swerdloff; Alisa Stephens-Shields; Shalender Bhasin; Jane A Cauley; Jill P Crandall; Glenn R Cunningham; Kristine E Ensrud; Thomas M Gill; Alvin M Matsumoto; Mark E Molitch; Marco Pahor; Peter E Preston; Xiaoling Hou; Denise Cifelli; Peter J Snyder Journal: J Clin Endocrinol Metab Date: 2018-02-01 Impact factor: 5.958
Authors: Varant Kupelian; Gretchen R Chiu; Andre B Araujo; Rachel E Williams; Richard V Clark; John B McKinlay Journal: Clin Endocrinol (Oxf) Date: 2009-09-21 Impact factor: 3.478
Authors: Samantha Huo; Anthony R Scialli; Sean McGarvey; Elizabeth Hill; Buğra Tügertimur; Alycia Hogenmiller; Alessandra I Hirsch; Adriane Fugh-Berman Journal: PLoS One Date: 2016-09-21 Impact factor: 3.240