Effect of testosterone replacement therapy on arterial stiffness in older hypogonadal men.
OBJECTIVE
To assess arterial stiffness in a cohort of hypogonadal males and to investigate the effect of testosterone replacement therapy on arterial properties in this specific group.


METHODS
Eighteen male patients with untreated acquired hypogonadism due to either adult-onset idiopathic hypogonadotropic hypogonadism (n=9) or pituitary tumor (n=9) and 12 age-, sex, and weight-matched eugonadal healthy controls were recruited for the study. Arterial properties, plasma glucose, lipid profile, total, and bioavailable testosterone (BT) levels were measured in fasting state. In the hypogonadal subjects, the effect of transdermal testosterone replacement therapy on arterial properties was studied by repeat noninvasive measurements at baseline, as well as 48 h and 90 days following the initiation of treatment.


METHODS
Arterial stiffness was evaluated using applanation tonometry and pulse wave analysis by three different standard devices that assess various measures of arterial stiffness: pulse wave velocity (PWV), augmentation index (AIx), and large/small artery compliance (C1 and C2).


RESULTS
Age- and blood pressure-adjusted PWV was significantly higher in hypogonadal men (8.90+/-2.29 vs 6.78+/-1.16 m/s in the control group; P=0.025). Testosterone therapy increased BT level from 2.01+/-1.04 to 4.68+/-2.43 and 7.83+/-6.2 nmol/l after 48 h and 3 months respectively (P=0.001). PWV decreased from 8.9+/-2.29 to 8.24+/-1.39 and 8.25+/-1.82 m/s after 48 h and 3 months of treatment respectively (P=0.03).


CONCLUSIONS
Male hypogonadism is associated with increased PWV, which is rapidly but incompletely ameliorated by normalization of circulating testosterone levels.
Yaron
Marianna
M
Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, 64239.
Greenman
Yona
Y
Rosenfeld
Joseph B
JB
Izkhakov
Elena
E
Limor
Rona
R
Osher
Etty
E
Shenkerman
Galina
G
Tordjman
Karen
K
Stern
Naftali
N
D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D001158:Arteries / Q000187:drug effects; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D005640:Follicle Stimulating Hormone / Q000097:blood; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000097:blood; D013739:Testosterone / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use*; D014655:Vascular Resistance / Q000187:drug effects*
D013739:Testosterone; D011388:Prolactin; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone