Controversies in testosterone replacement therapy: testosterone and cardiovascular disease.
Controversies in testosterone replacement therapy: testosterone and cardiovascular disease.
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DOI：
10.4103/1008-682x.146968
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发表时间：
2015-03
影响因子：
2.9
通讯作者：
Miner M
中科院分区：
文献类型：
--
作者：
Hwang K;Miner M
睾酮在男性心血管 (CV) 健康中的作用存在争议。数据表明，临床性腺功能减退症的病情和治疗均与心血管死亡率降低相关。然而，最近的两项研究表明，接受睾酮替代疗法治疗的性腺功能减退受试者新发心血管事件的发生率较高。媒体越来越关注接受睾酮治疗的男性患心血管疾病的风险。迄今为止，还没有长期前瞻性研究来确定安全性。过去 30 年的文献表明，睾酮水平低的男性不仅可能增加心血管风险，而且睾酮治疗的益处甚至可能降低这种风险。我们在此回顾最近受到如此严格审查的研究。本文旨在对睾酮水平和心血管风险进行全面回顾，为临床医生提供在治疗临床性腺功能减退症患者时做出明智的临床决策所需的事实。
The role of testosterone in the cardiovascular (CV) health of men is controversial. Data suggest that both the condition and treatment of clinical hypogonadism is associated with decreased CV mortality; however, two recent studies suggest that hypogonadal subjects treated with testosterone replacement therapy have a higher incidence of new CV events. There has been increased media attention concerning the risk of CV disease in men treated with testosterone. Until date, there are no long-term prospective studies to determine safety. Literature spanning over the past 30 years has suggested that not only is there a possible increased CV risk in men with low levels of testosterone, but the benefits from testosterone therapy may even lower this risk. We review here the recent studies that have garnered such intense scrutiny. This article is intended as a thorough review of testosterone levels and CV risk, providing the clinician with the facts needed to make informed clinical decisions in managing patients with clinical hypogonadism.