Journal List > Korean J Androl > v.29(1) > 1033067

Kim, Kim, and Moon: Effects of Androgen on the Cardiovascular System in the Aging Male

Abstract

Testosterone decrease in men with age has become well established. As such, several modes of testosterone replacement therapy have become available, primarily for supplementation to alleviate the effects of age associated hypogonadism, as manifested by frailty, sarcopenia, poor muscle quality, decreased libido and erectile functions. Recent investigations have found significant association between hypogonadism and cardiovascular disease, type 2 diabetes, obesity and dyslipidemia. The association is more clearly presented in patients receiving androgen deprivation therapy for prostate cancer. Furthermore, testosterone supplementation restores arterial vasoreactivity, reduces proinflammatory cytokines, total cholesterol, and triglyceride levels, and improves endothelial function and insulin sensitivity. Future long term trials should be performed to identify persistent benefits and safety of this treatment.

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Fig. 1.
Kaplan-Meier survival curves for 3 testosterone level groups.1
kja-29-10f1.tif
Fig. 2.
The interrelationships between metabolic syndrome and hypogonadism with chronic illnesses and cardiovascular risks are shown and do appear to be quite inter-14
kja-29-10f2.tif
Fig. 3.
Immune and inflammatory reaction.50
kja-29-10f3.tif
Fig. 4.
Group I: high initial fasting glucose, Group II: low initial fasting glucose. Glucose level of group I decreased more than that of group II.62
kja-29-10f4.tif
Table 1.
Cardiovascular disease and type 2 diabetes
Hypogonadism Testosterone replacement therapy
Cardiovascular disease - Increased mortality - Short term relief: angina, vasodilatory effects
- Obesity - Beneficial cytokine profile: suppress proinflammatory cytokines
- Poor lipid profile: higher triglycerides, lower HDL - Improved ischemic threshold
Type 2 diabetes - Concomitant association increased with high BMI - Improved glycemic control: reduced blood glucose and glycated hemoglobin
- Increased insulin associated with reduced SHBG concentrations
- Increased insulin resistance
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