scholarly journals Effect of Testosterone Treatment on Volumetric Bone Density and Strength in Older Men With Low Testosterone

2017 ◽  
Vol 177 (4) ◽  
pp. 471 ◽  
Author(s):  
Peter J. Snyder ◽  
David L. Kopperdahl ◽  
Alisa J. Stephens-Shields ◽  
Susan S. Ellenberg ◽  
Jane A. Cauley ◽  
...  
JAMA ◽  
2017 ◽  
Vol 317 (7) ◽  
pp. 717 ◽  
Author(s):  
Susan M. Resnick ◽  
Alvin M. Matsumoto ◽  
Alisa J. Stephens-Shields ◽  
Susan S. Ellenberg ◽  
Thomas M. Gill ◽  
...  

2017 ◽  
Vol 103 (2) ◽  
pp. 681-688 ◽  
Author(s):  
Emile R Mohler ◽  
Susan S Ellenberg ◽  
Cora E Lewis ◽  
Nanette K Wenger ◽  
Matthew J Budoff ◽  
...  

Abstract Context Studies of the possible cardiovascular risk of testosterone treatment are inconclusive. Objective To determine the effect of testosterone treatment on cardiovascular biomarkers in older men with low testosterone. Design Double-blind, placebo-controlled trial. Setting Twelve academic medical centers in the United States. Participants In all, 788 men ≥65 years old with an average of two serum testosterone levels <275 ng/dL who were enrolled in The Testosterone Trials. Intervention Testosterone gel, the dose adjusted to maintain the testosterone level in the normal range for young men, or placebo gel for 12 months. Main Outcome Measures Serum markers of cardiovascular risk, including lipids and markers of glucose metabolism, fibrinolysis, inflammation, and myocardial damage. Results Compared with placebo, testosterone treatment significantly decreased total cholesterol (adjusted mean difference, −6.1 mg/dL; P < 0.001), high-density lipoprotein cholesterol (adjusted mean difference, −2.0 mg/dL; P < 0.001), and low-density lipoprotein cholesterol (adjusted mean difference, −2.3 mg/dL; P = 0.051) from baseline to month 12. Testosterone also slightly but significantly decreased fasting insulin (adjusted mean difference, −1.7 µIU/mL; P = 0.02) and homeostatic model assessment‒insulin resistance (adjusted mean difference, −0.6; P = 0.03). Testosterone did not change triglycerides, d-dimer, C-reactive protein, interleukin 6, troponin, glucose, or hemoglobin A1c levels more than placebo. Conclusions and Relevance Testosterone treatment of 1 year in older men with low testosterone was associated with small reductions in cholesterol and insulin but not with other glucose markers, markers of inflammation or fibrinolysis, or troponin. The clinical importance of these findings is unclear and requires a larger trial of clinical outcomes.


2015 ◽  
Vol 30 (3) ◽  
pp. 562-569 ◽  
Author(s):  
Elizabeth N Martin ◽  
Elizabeth M Haney ◽  
Jackie Shannon ◽  
Jane A Cauley ◽  
Kristine E Ensrud ◽  
...  

JAMA ◽  
2017 ◽  
Vol 317 (7) ◽  
pp. 708 ◽  
Author(s):  
Matthew J. Budoff ◽  
Susan S. Ellenberg ◽  
Cora E. Lewis ◽  
Emile R. Mohler ◽  
Nanette K. Wenger ◽  
...  

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Marcelo Rodrigues dos Santos ◽  
Shalender Bhasin

The substantial increase in life expectancy of men has focused growing attention on quality-of-life issues associated with reproductive aging. Serum total and free testosterone levels in men, after reaching a peak in the second and third decade of life, decline gradually with advancing age. The trajectory of age-related decline is affected by comorbid conditions, adiposity, medications, and genetic factors. Testosterone treatment of older men with low testosterone levels improves overall sexual activity, sexual desire, and erectile function; improves areal and volumetric bone density, as well as estimated bone strength in the spine and the hip; corrects unexplained anemia of aging; increases skeletal muscle mass, strength and power, self-reported mobility, and some measures of physical function; and modestly improves depressive symptoms. The long-term effects of testosterone on major cardiovascular events and prostate cancer risk remain unclear. The Endocrine Society recommends against testosterone therapy of all older men with low testosterone levels but suggests consideration of treatment on an individualized basis in men who have consistently low testosterone levels and symptoms or conditions suggestive of testosterone deficiency. Expected final online publication date for the Annual Review of Medicine, Volume 72 is January 27, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.


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