Prospective study of effect of androgens on serum inflammatory markers in men.
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.


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.
Department of Cardiology, Royal Prince Alfred Hospital and The Heart Research Institute.
Martin K C
MK
Ng
Peter Y
PY
Liu
Andrew J
AJ
Williams
Shirley
S
Nakhla
Lam P
LP
Ly
David J
DJ
Handelsman
David S
DS
Celermajer
D000368:Aged; D000728:Androgens / Q000172:deficiency / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D013196:Dihydrotestosterone / Q000627:therapeutic use; D004311:Double-Blind Method; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000378:metabolism; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D008297:Male; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D012995:Solubility; D013739:Testosterone / Q000097:blood / Q000172:deficiency; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D000728:Androgens; D015415:Biomarkers; D006063:Chorionic Gonadotropin; D011994:Recombinant Proteins; D019010:Vascular Cell Adhesion Molecule-1; D013196:Dihydrotestosterone; D018799:Intercellular Adhesion Molecule-1; D013739:Testosterone; D002097:C-Reactive Protein