Relationships between endogenous and exogenous testosterone and cardiovascular disease in men.
Relationships between endogenous and exogenous testosterone and cardiovascular disease in men.
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男性内源性和外源睾丸激素与心血管疾病之间的关系。
DOI：
10.1007/s11154-022-09752-7
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发表时间：
2022-12
影响因子：
8.2
通讯作者：
Anawalt, Bradley D.
中科院分区：
文献类型：
--
作者：
Thirumalai, Arthi;Anawalt, Bradley D.
在这篇叙述性综述中，我们讨论了关于内源性和外源性睾酮对男性心血管影响的争议的证据。随访约5-15年的前瞻性队列研究一般表明，血清内源性睾酮浓度与复合主要心血管事件、心血管死亡和总死亡率之间没有关联或可能存在负相关关系。大型数据库的药物流行病学研究一般表明，睾酮治疗与发生的重大心血管事件之间没有关联，一些药物流行病学研究表明，与总体死亡率降低有关。随机、安慰剂对照试验表明，服用1-3年睾酮治疗不会增加总体主要心血管事件的发生率。这些安慰剂对照试验有很大的局限性，包括参与者人数少，睾酮治疗和随访持续时间短，以及缺乏对心血管事件的系统判断。总体而言，证据表明，内源性睾酮浓度和生理剂量的睾酮治疗对心血管结果的发生率没有或几乎没有影响。对于心血管事件高危患者(例如，最近有心肌梗死或中风的男性和复发性特发性深静脉血栓患者)，没有足够的证据得出睾酮治疗的结论。一般来说，临床医生应该避免给性腺功能低下的男性或血清睾酮浓度略低至正常的低水平且未发现下丘脑-垂体-睾丸轴紊乱的男性开超生理学睾酮治疗，因为存在不确定的心血管风险，而且缺乏已证实的健康益处。对于大多数真正患有性腺功能减退症的男性来说，睾酮治疗的好处超过了对心血管有害影响的潜在风险。
In this narrative review, we discuss the evidence about the controversy about the cardiovascular effects of endogenous and exogenous testosterone in men. Prospective cohort studies with follow-up of ~5–15 years generally indicate no association or a possible inverse relationship between serum endogenous testosterone concentrations and composite major cardiovascular events, cardiovascular deaths and overall mortality. Pharmacoepidemiological studies of large databases generally show no association between testosterone therapy and incident major cardiovascular events, and some pharmacoepidemiological studies demonstrate an association with decreased overall mortality. Randomized, placebo-controlled trials indicate that there is no increased incidence of overall major cardiovascular events with 1–3 years of testosterone therapy. These placebo-controlled trials have major limitations including small numbers of participants, short duration of testosterone therapy and follow-up, and lack of systematic adjudication of cardiovascular events. Overall, the evidence indicates that endogenous testosterone concentrations and testosterone therapy at physiological dosages confer no or minimal effects on the incidence of cardiovascular outcomes. There is insufficient evidence to make conclusions about testosterone therapy for patients at high risk of cardiovascular events (e.g., men with recent myocardial infarctions or stroke and men with recurrent idiopathic deep venous thromboses). In general, clinicians should avoid prescribing supraphysiological testosterone therapy to hypogonadal men or men with slightly low to low-normal serum testosterone concentrations and no identified disorder of the hypothalamus-pituitary–testicular axis because of the uncertain cardiovascular risks and the lack of proven health benefits. For most men with bona fide hypogonadism, benefits of testosterone therapy exceed the potential risk of adverse cardiovascular effects.
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DOI：
10.1056/nejmoa1000485
发表时间：
2010-07-08
期刊：
The New England journal of medicine
影响因子：
--
作者：
Basaria S;Coviello AD;Travison TG;Storer TW;Farwell WR;Jette AM;Eder R;Tennstedt S;Ulloor J;Zhang A;Choong K;Lakshman KM;Mazer NA;Miciek R;Krasnoff J;Elmi A;Knapp PE;Brooks B;Appleman E;Aggarwal S;Bhasin G;Hede-Brierley L;Bhatia A;Collins L;LeBrasseur N;Fiore LD;Bhasin S
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Bhasin S
DOI：
10.1001/jama.2016.21043
发表时间：
2017-02-21
期刊：
JAMA
影响因子：
--
作者：
Budoff MJ;Ellenberg SS;Lewis CE;Mohler ER 3rd;Wenger NK;Bhasin S;Barrett-Connor E;Swerdloff RS;Stephens-Shields A;Cauley JA;Crandall JP;Cunningham GR;Ensrud KE;Gill TM;Matsumoto AM;Molitch ME;Nakanishi R;Nezarat N;Matsumoto S;Hou X;Basaria S;Diem SJ;Wang C;Cifelli D;Snyder PJ
通讯作者：
Snyder PJ
影响因子：
3.2
作者：
Layton JB;Li D;Meier CR;Sharpless JL;Stürmer T;Brookhart MA
通讯作者：
Brookhart MA
DOI：
10.5534/wjmh.200109
发表时间：
2021-07
期刊：
The world journal of men's health
影响因子：
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作者：
Corona G;Filippi S;Bianchi N;Dicuio M;Rastrelli G;Concetti S;Sforza A;Maggi M
通讯作者：
Maggi M
影响因子：
3.2
作者：
Chan, Yi X.;Knuiman, Matthew W.;Yeap, Bu B.
通讯作者：
Yeap, Bu B.