Androgen deficiency: effects on body composition

Miller, Karen K.

doi:10.1007/s11102-008-0121-7

Cited by 40 publications

(36 citation statements)

References 76 publications

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“…22,23 In addition to sexual dysfunction, testosterone deficiency is also associated with the loss of muscle mass. 16,24 In our study, patients with low testosterone levels had lower handgrip strength and lower s-creatinine levels. In stable HD patients, s-creatinine levels are a crude reflection of muscle mass and fairly correlate with handgrip strength and lean body mass.…”

Section: Discussionsupporting

confidence: 48%

Low Serum Testosterone Increases Mortality Risk among Male Dialysis Patients

Carrero

Qureshi

Parini

et al. 2009

Journal of the American Society of Nephrology

170

159

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Men treated with hemodialysis (HD) have a very poor prognosis and an elevated risk of premature cardiovascular disease (CVD). In the general population, associations between low testosterone concentrations and cardiovascular risk have been suggested. We performed a prospective observational study involving a well characterized cohort of 126 men treated with HD to examine the relationship between testosterone concentration and subsequent mortality during a mean follow-up period of 41 mo. Independent of age, serum creatinine, and sexual hormone binding globulin (SHBG), testosterone levels inversely and strongly associated with the inflammatory markers IL-6 and CRP. Patients with a clinical history of CVD had significantly lower testosterone levels. During follow up, 65 deaths occurred, 58% of which were a result of CVD. Men with testosterone values in the lowest tertile had increased all-cause and CVD mortality (crude hazard ratios [HRs] 2.03 [95% CI 1.24 to 3.31] and 3.19 [1.49 to 6.83], respectively), which persisted after adjustment for age, SHBG, previous CVD, diabetes, ACEi/ARB treatment, albumin, and inflammatory markers, but was lost after adjustment for creatinine. In summary, among men treated with HD, testosterone concentrations inversely correlate with all-cause and CVDrelated mortality, as well as with markers of inflammation. Hypogonadism may be an additional treatable risk factor for patients with chronic kidney disease.

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Section: Discussionsupporting

confidence: 48%

Low Serum Testosterone Increases Mortality Risk among Male Dialysis Patients

Carrero

Qureshi

Parini

et al. 2009

Journal of the American Society of Nephrology

170

159

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“…Such observation agrees with previous reports in nonrenal populations (28 -30) and is consistent with the hypothesis that obesity, via direct leptin action (31) or adipocyte synthesis of aromatase enzyme (32), is able to suppress testosterone production. As a consequence, obese people have less muscle mass (33). Whether the hyperleptinemia observed in HD (34) may further contribute to testosterone deficiency is a hypothesis that merits further attention.…”

Section: Discussionmentioning

confidence: 99%

Endogenous Testosterone and Mortality in Male Hemodialysis Patients

Güngör

Kırçelli

Carrero

et al. 2010

Clinical Journal of the American Society of Nephrology

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Background and objectives: Low serum testosterone levels in hemodialysis (HD) patients have recently been associated with cardiovascular risk factors and increased mortality. To confirm this observation, we investigated the predictive role of serum total testosterone levels on mortality in a large group of male HD patients from Turkey.Design, settings, participants, & measurements: A total of 420 prevalent male HD patients were sampled in March 2005 and followed up for all-cause mortality. Serum total testosterone levels were measured by ELISA at baseline and studied in relation to mortality and cardiovascular risk profile.Results: Mean testosterone level was 8.69 ؎ 4.10 (0.17 to 27.40) nmol/L. A large proportion of patients (66%) had testosterone deficiency (<10 nmol/L). In univariate analysis, serum testosterone levels were positively correlated with creatinine and inversely correlated with age, body mass index, and lipid parameters. During an average follow-up of 32 months, 104 (24.8%) patients died. The overall survival rate was significantly lower in patients within the low testosterone tertile (<6.8 nmol/L) compared with those within the high tertile (>10.1 nmol/L; 64 versus 81%; P ‫؍‬ 0.004). A 1-nmol/L increase in serum testosterone level was associated with a 7% decrease in overall mortality (hazard ratio 0.93; 95% confidence interval 0.89 to 0.98; P ‫؍‬ 0.01); however, this association was dependent on age and other risk factors in adjusted Cox regression analyses.Conclusions: Testosterone deficiency is common in male HD patients. Although testosterone levels, per se, predicted mortality in this population, this association was largely dependent on age.

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“…In women, however, consequences of low testosterone or androgen deficiency on CV risk factors and diseases are poorly studied. Miller (26), for instance, reviewed that physiological testosterone replacement in women shows a positive effect on the restoration of a normal body composition, however, not consistently (27).…”

Section: Discussionmentioning

confidence: 99%

Low testosterone levels predict all-cause mortality and cardiovascular events in women: a prospective cohort study in German primary care patients

Sievers

Klotsche²,

Pieper³

et al. 2010

European Journal of Endocrinology

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Objective: Although associations between testosterone and cardiovascular (CV) morbidity in women have been proposed, no large prospective study has evaluated potential associations between testosterone and mortality in women. The objective was to determine whether baseline testosterone levels in women are associated with future overall or CV morbidity and mortality. Design: Prospective cohort study with a 4.5-year follow-up period. Methods: From a representative sample of German primary care practices, 2914 female patients between 18 and 75 years were analyzed for the main outcome measures: CV risk factors, CV diseases, and all-cause mortality. Results: At baseline, the study population was aged 57.96G14.37 years with a mean body mass index of 26.71G5.17 kg/m 2 . No predictive value of total testosterone for incident CV risk factors or CV diseases was observed in logistic regressions. Patients with total testosterone levels in the lowest quintile Q1, however, had a higher risk to die of any cause or to develop a CV event within the follow-up period compared to patients in the collapsed quintiles Q2-Q5 in crude and adjusted Cox regression models (all-cause mortality: Q2-Q5 versus Q1: crude hazard ratios (HR) 0.49, 95% confidence interval (CI) 0.33-0.74; adjusted HR 0.62, 95% CI 0.42-0.939; CV events: Q2-Q5 versus Q1: crude HR 0.54, 95% CI 0.38-0.77; adjusted HR 0.68, 95% CI 0.48-0.97). Kaplan-Meier curves revealed similar data. Conclusions: Low baseline testosterone in women is associated with increased all-cause mortality and incident CV events independent of traditional risk factors.

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Androgen deficiency: effects on body composition

Cited by 40 publications

References 76 publications

Low Serum Testosterone Increases Mortality Risk among Male Dialysis Patients

Low Serum Testosterone Increases Mortality Risk among Male Dialysis Patients

Endogenous Testosterone and Mortality in Male Hemodialysis Patients

Low testosterone levels predict all-cause mortality and cardiovascular events in women: a prospective cohort study in German primary care patients

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