This is Part II to my response on the recent Milwaukee Journal Sentinel
article regarding testosterone (T) replacement with the headline, "UW tied to male hormone marketing: Testosterone prescriptions soar despite weak research, risks." Here's a link:http://www.jsonline.com/features/health/52802117.html
So the article also claimed that
“concerns that it may increase … cardiovascular disease”
Here I present articles published (364 articles matched), most of them within the last 9 months disputing this point. I didn’t have to go beyond the first page of my medline search to get these:
Endogenous testosterone and the prospective association with carotid atherosclerosis in men: the Tromsø study
Vikan T. Johnsen SH. Schirmer H. Njolstad I. Svartberg J. European Journal of Epidemiology
. 24(6):289-95, 2009.
In the cross-sectional study, we found an inverse association between testosterone levels and total carotid plaque area (P < 0.05), after adjusting for age, systolic blood pressure, smoking and use of lipid-lowering drugs.
Androgens and cardiovascular disease.
Liu PY, Death AK, Handelsman DJEndocrine Reviews
Observational studies show that blood testosterone concentrations are consistently lower among men with cardiovascular disease, suggesting a possible preventive role for testosterone therapy, which requires critical evaluation by further prospective studies. Short-term interventional studies show that testosterone produces a modest but consistent improvement in cardiac ischemia over placebo, comparable to the effects of existing antianginal drugs.
Reduced testosterone levels in males with lone atrial fibrillation.
Lai J, Zhou D, Xia S, Shang Y, Want L, Zheng L, Zhu JClinical Cardiology
. 32(1):43-6, 2009 Jan
Mean levels of testosterone were significantly lower in subjects with lone atrial fibrillation when compared with controls (476 ng/dl versus 514 ng/dl, p = 0.005). CONCLUSION: Reduced testosterone levels may be associated with susceptibility to lone atrial fibrillation in men.
The dark side of testosterone deficiency: I. Metabolic syndrome and erectile dysfunction. [Review] [121 refs]
Traish AM. Guay A. Feeley R. Saad F. Journal of Andrology
. 30(1):10-22, 2009 Jan-Feb.
The metabolic syndrome (MetS) is considered the most important public health threat of the 21st century. This syndrome is characterized by a cluster of cardiovascular risk factors including increased central abdominal obesity, elevated triglycerides, reduced high-density lipoprotein, high blood pressure, increased fasting glucose, and hyperinsulinemia.
Central or abdominal obesity, measured as WC, is a classical feature of MetS and is associated with reduced total testosterone levels (Pasquali et al, 1997; Svartberg et al, 2004a,b, 2007; Osuna et al, 2006).
Other studies have confirmed the significant inverse correlation between total T and obesity (Pasquali et al, 1991; Laaksonen et al, 2003; Kalyani and Dobs, 2007). Therefore, men with visceral obesity are in a vicious cycle as T deficiency leads to reduced lipolysis, reduced metabolic rate, visceral fat deposition, and insulin resistance.
The dark side of testosterone deficiency: II. Type 2 diabetes and insulin resistance. [Review] [99 refs]
Traish AM. Saad F. Guay A. Journal of Andrology
. 30(1):23-32, 2009 Jan-Feb.
Low testosterone precedes elevated fasting insulin, glucose, and hemoglobin A1c (HbA1C) values and may even predict the onset of diabetes. Treatment of prostate cancer patients with surgical or medical castration exacerbates insulin resistance (IR) and glycemic control, strengthening the link between testosterone deficiency and onset of type 2 diabetes (T2D) and IR. Androgen therapy of hypogonadal men improves insulin sensitivity, fasting glucose, and HbA1c levels. We suggest that androgen deficiency is associated with IR, T2D, MetS, and with increased deposition of visceral fat, which serves as an endocrine organ, producing inflammatory cytokines and thus promoting endothelial dysfunction and vascular disease.
The dark side of testosterone deficiency: III. Cardiovascular disease. [Review] [99 refs]
Traish AM. Saad F. Feeley RJ. Guay A. Journal of Andrology
. 30(1):23-32, 2009 Jan-Feb.
Androgen deficiency is associated with increased levels of total cholesterol, low-density lipoprotein, increased production of proinflammatory factors, and increased thickness of the arterial wall and contributes to endothelial dysfunction. Testosterone supplementation restores arterial vasoreactivity; reduces proinflammatory cytokines, total cholesterol, and triglyceride levels; and improves endothelial function but also might reduce high-density lipoprotein levels.
And finally a few others in summary:
- Diaz-Arnjonilla, et al Intl J of Impot Res 2009 —
- Low T in obese men
- Lot T in men with metab syn and DM
- BMI inv propor to serum total T
- Schandt et al Current Opinion in Urology 2009 — Link of androgen deprivation therapy in prostate cancer to development of metabolic syndrome
- Corona et al J of Sex Med 2008 — Low levels of androgens in men with erectile dysfunction and obesity
- Dandona P et al Postgrad Medicine 2009—
- Hypogonadotropic hypogonad seen in DM2 is assoc with obesity but not duration of DM2
- 1/3 of DM2 have low T