Effect of aromatase inhibition on lipids and inflammatory markers of cardiovascular disease in elderly men with low testosterone levels.
OBJECTIVE
Although androgen replacement has been shown to have beneficial effects in hypogonadal men, there is concern that androgens may deleteriously affect cardiovascular risk in elderly men.


METHODS
Anastrozole is an oral aromatase inhibitor that normalizes serum testosterone levels and decreases oestradiol levels modestly in elderly men with mild hypogonadism. Thirty-seven elderly hypogonadal men were randomized to receive either anastrozole 1 mg daily (n = 12), anastrozole 1 mg twice weekly (n = 11), or daily placebo (n = 14) for 12 weeks in a double-blind fashion.


METHODS
Men aged 62-74 years with mild hypogonadism defined by testosterone levels less than 350 ng/dl.


METHODS
Serum levels of fasting lipids, C-reactive protein (CRP), interleukin-6 (IL-6), intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and homeostatic model assessment (HOMA) scores were measured at 4-week intervals.


RESULTS
Treatment with anastrozole did not significantly affect fasting lipids, inflammatory markers (IL-6, CRP), adhesion molecules (ICAM-1, VCAM-1) or insulin sensitivity (HOMA). There was, however, a positive correlation between changes in serum triglycerides and changes in serum oestradiol levels (P = 0.04).


CONCLUSIONS
While short-term administration of anastrozole is an effective method of normalizing serum testosterone levels in elderly men with mild hypogonadism, it does not appear to adversely affect lipid profiles, inflammatory markers of cardiovascular risk or insulin resistance.
Dougherty
Ryan H
RH
Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.
Rohrer
Jacqueline L
JL
Hayden
Douglas
D
Rubin
Stephen D
SD
Leder
Benjamin Z
BZ
D000368:Aged; D000704:Analysis of Variance; D000077384:Anastrozole; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood*; D016009:Chi-Square Distribution; D006706:Homeostasis; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000188:drug therapy*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009570:Nitriles / Q000627:therapeutic use*; D012307:Risk Factors; D013739:Testosterone / Q000097:blood*; D014230:Triazoles / Q000627:therapeutic use*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D047072:Aromatase Inhibitors; D015415:Biomarkers; D015850:Interleukin-6; D008055:Lipids; D009570:Nitriles; D014230:Triazoles; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D000077384:Anastrozole; D013739:Testosterone; D002097:C-Reactive Protein