A role for dihydrotestosterone treatment in older men?
A role for dihydrotestosterone treatment in older men?
复制标题
双氢睾酮治疗对老年男性有何作用？
DOI：
10.1038/aja.2010.173
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发表时间：
2011
影响因子：
2.9
通讯作者：
Page,StephanieT
中科院分区：
文献类型：
--
作者：
Roth,MaraY;Page,StephanieT
Testosterone supports bone development and strength, provides anabolic effects for maintenance of lean muscle mass, and contributes to normal sexual function and libido. Circulating testosterone concentrations gradually decline as men age, rendering nearly 20% of men biochemically hypogonadal by age 60. 1 Current guidelines recommend androgen replacement, when indicated, using testosterone delivery via injection or transdermally. 2 However, due to a lack of large, long-term clinical trials, the risks of testosterone replacement are not clearly known. Exogenous testosterone can be associated with negative effects, such as polycythemia, and might be associated with prostate growth, such that it is currently contraindicated in men with prostate cancer. 2 Testosterone is metabolized in vivo to both estradiol, via aromatization, and dihydrotestosterone (DHT) via 5a-reduction, both of which are physiologically active. In particular, due to very high concentrations in the prostate, DHT is thought to play an important, yet unclear, role in prostate health. Moreover, DHT is a more potent androgen than testosterone, and might be clinically useful in treating hypogonadism. To determine the effects and safety of exogenous DHT in older men, a group from the ANZAC Research Institute (Australia) recently published a 2-year randomized, placebo-controlled trial in the Annals of Internal Medicine entitled,‘Long-term effects of dihydrotestosterone treatment on prostate growth in healthy, middle-aged men without prostate disease’. 3 Idan and colleagues report results from a comprehensive trial in 114 healthy, eugonadal men who received 2 years of either DHT treatment with a transdermal, pharmacologic dose of 70 mg DHT gel daily, or matching placebo gel. The primary outcome was prostate volume measured by ultrasonography, and secondary outcomes included bone mineral density, body composition, serum lipids and hormones, and quality of life questionnaires. There were no serious adverse events and a high retention rate for such a long study (71% completed all study procedures). As expected, the DHT-treated group had a 10-fold increase in serum DHT levels, well above the normal range of circulating DHT, and a concomitant decrease in serum testosterone and estradiol concentrations which were all unchanged in the placebo group. In summary, they report no DHT-specific effects on prostate volume, with both the treatment and placebo groups experiencing a similar increase in prostate volume and prostate specific antigen during the study. Compared to placebo, the DHT group demonstrated a decrease in total body fat mass and in bone mineral density at the spine, but not at the hip, and increased lean body mass, serum hemoglobin and creatinine. Both groups experienced a similar rise in low-density lipoproteins and decline in high-density lipoproteins. None of the quality of life indicators differed between the treatment groups in this eugonadal cohort.DHT is a highly potent,‘pure androgen’which cannot be aromatized, yet the authors hypothesized that exogenous DHT would reduce prostate size due to:(i) negative feedback on gonadotropin and testosterone production; and (ii) its metabolism to 3bandrostanediol-5a which has been suggested to inhibit prostate growth. 4 On the other hand, 5a-reducatase inhibitors which block testosterone conversion to DHT clearly decrease prostate volume, presumably by reducing serum and intraprostatic concentrations of DHT. 5 Prior, shorter-term studies of DHT gel in hypogonadal men reported no impact on prostate volume. 6, 7 This study aimed to extend these findings and, if their hypothesis was correct …
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一项双盲、安慰剂对照、随机临床试验，研究透皮二氢睾酮凝胶对部分雄激素缺乏的老年男性的肌肉力量、活动能力和生活质量的影响。
DOI：
10.1210/jcem.86.9.7821
发表时间：
2001
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
L. P. Ly;M. Jimenez;T. Zhuang;D. Celermajer;A. Conway;David Handelsman
通讯作者：
David Handelsman
影响因子：
5.8
作者：
Bhasin, Shalender;Cunningham, Glenn R.;Montori, Victor M.
通讯作者：
Montori, Victor M.
性腺功能减退男性中合成雄激素 7 α-甲基-19-去甲睾酮的组织选择性的证据。
影响因子：
5.8
作者：
Richard A. Anderson;A. Michael Wallace;N. Sattar;Narendar Kumar;K. Sundaram
通讯作者：
K. Sundaram
双氢睾酮治疗对无前列腺疾病的健康中年男性前列腺生长的长期影响
影响因子：
39.2
作者：
A. Idan;K. Griffiths;D. T. Harwood;M. Seibel;L. Turner;A. Conway;David Handelsman
通讯作者：
David Handelsman
雌二醇的生理水平会刺激正常男性血浆高密度脂蛋白2胆固醇水平。
DOI：
10.1210/jcem.78.4.8157711
发表时间：
1994
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Bagatell,CJ;Knopp,RH;Rivier,JE;Bremner,WJ
通讯作者：
Bremner,WJ