Could Testosterone Replacement Therapy in Hypogonadal Men Ameliorate Anemia, a Cardiovascular Risk Factor? An Observational, 54-Week Cumulative Registry Study

Zhang, Li Tao; Shin, Yu Seob; Kim, Ji Yong; Park, Jong Kwan

doi:10.1016/j.juro.2015.10.130

Cited by 21 publications

(16 citation statements)

References 25 publications

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“…Although men with testosterone deficiency are not always diagnosed with anemia, the relationship between testosterone deficiency and low hemoglobin is significant, suggesting that low testosterone is one of the causal factors of anemia. Zhang et al [31] investigated the effects of testosterone treatment in 58 patients with testosterone levels <235 ng/dL and mild symptoms of testosterone deficiency. Hb, hematocrit, anemia risk factors, whole blood viscosity, and anthropometrics were measured.…”

Section: Impact Of Testosterone Deficiency and Testosterone Treatmentmentioning

confidence: 99%

Testosterone Deficiency and Testosterone Treatment in Older Men

et al. 2016

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Frailty is a clinical condition related to changes in metabolism, to sarcopenia, and to decline in muscle mass and strength, bone mineral density, and physical function with aging. The pathophysiology of frailty is multifactorial and associated with comorbidities. Testosterone is implicated in regulating metabolic functions, maintenance of muscle and bone, and inhibition of adipogenesis. In older individuals, reduced testosterone is thought to contribute to an altered state of metabolism, loss of muscle and bone, and increased fat, leading to sarcopenia, sarcopenic obesity, and frailty. While no direct relationship between testosterone deficiency (commonly known as hypogonadism) and frailty has been established (due to the multifactorial nature of frailty), clinical evidence suggests that testosterone deficiency is associated with increased sarcopenia and obesity. Testosterone treatment in frail older men with limited mobility and with testosterone deficiency improved insulin resistance, glucose metabolism, and body composition. These changes contribute to better physical function and improved quality of life. Because frailty increases disability, comorbidities, and the risk of hospitalization, institutionalization, and mortality in older men, it is warranted to explore the potential usefulness of testosterone treatment in frail men with hypogonadism in order to attenuate the progression of sarcopenia and frailty. In this paper, we will discuss the impact of testosterone deficiency on frailty and the potential role of testosterone treatment in ameliorating and reducing the progression of frailty. Such an approach may reduce disability and the risk of hospitalization and increase functional independence and quality of life.

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Section: Impact Of Testosterone Deficiency and Testosterone Treatmentmentioning

confidence: 99%

Testosterone Deficiency and Testosterone Treatment in Older Men

et al. 2016

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“…Thirty‐one Caucasians (age: median [IQR] 55.0 years [49.0‐68.0]; total duration of follow‐up 6.1 years [2.9‐9.3]) and 19 South Asians (age: 52.0 years [38.0‐69.0]; duration of follow‐up 6.5 years [1.3‐8.4]) were treated with TU during the study period (see Table ). On average, the Caucasian group had 18 injection treatments compared with the South Asian group who had 16 injection treatments . This was not significantly different between the groups ( P = .3993).…”

Section: Resultsmentioning

confidence: 82%

“…Both ethnic groups returned to their baseline levels over the eight years. Jones et al reported the risk of erythrocytosis following TRT could be attributed to EPO production, bone marrow stimulation and increased iron bioavailability with higher risk with intramuscular therapy . Zhang et al found that TU therapy significantly increased haematocrit and haemoglobin in a cohort of 1221 ageing men.…”

Section: Discussionmentioning

confidence: 99%

“…Jones et al reported the risk of erythrocytosis following TRT could be attributed to EPO production, bone marrow stimulation and increased iron bioavailability with higher risk with intramuscular therapy . Zhang et al found that TU therapy significantly increased haematocrit and haemoglobin in a cohort of 1221 ageing men. Shin et al showed in a cross‐sectional study that in ageing men, reduced serum testosterone was associated with reduced haematocrit.…”

Section: Discussionmentioning

confidence: 99%

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Long‐term testosterone undecanoate replacement therapy: Impact of ethnicity

Kempegowda

Quinn

Chandan

et al. 2020

Clinical Endocrinology

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Background: Testosterone replacement therapy (TRT) is indicated for symptomatic male hypogonadism. However, the safety and efficacy profiles across different ethnicities for long-term TRT remain unclear.Objective: To measure the impact of ethnicity on various biochemical parameters following testosterone undecanoate (TU) replacement. Method:A retrospective analysis of 50 male patients treated with TU from 2006 to 2017 in a large secondary care centre was performed. Changes in total testosterone, PSA, haematocrit, haemoglobin, total cholesterol and low-density lipoprotein (LDL) over eight years of treatment were analysed. Wilcoxon rank sum test was used to assess differences in these parameters between Caucasians and South Asians.Results: Thirty-one Caucasians (age: median (IQR) 55.0 years (49.0-68.0); total duration of follow-up 6.1 years (2.9-9.3)) and 19 South Asians (age: median (IQR) 52.0 years (38.0-69.0); duration of follow-up 6.5 years (1.3-8.4)) were treated with TU during the study period. There was no significant difference in total testosterone levels between the two ethnicities. We noted a higher free and bioavailable testosterone in South Asians than Caucasians, albeit within their reference range. PSA was higher in Caucasians than South Asians at two and eight years of TU therapy. After one year of TRT, haematocrit was higher in South Asians than Caucasians at one year, whereas LDL and total cholesterol were significantly higher in Caucasians than South Asians. Conclusions:Caucasians have a tendency towards increased PSA, total cholesterol and LDL compared with South Asians with TU replacement therapy. There is a higher increment of haematocrit in South Asians following one year of TU replacement therapy. All biochemical changes following TRT were within the respective reference ranges suggesting no apparent risk of prostate cancer and venous thromboembolism. K E Y W O R D S ethnicity, haematocrit, hypogonadism, low-density lipoprotein, PSA, testosterone undecanoate, total cholesterol | 429 KEMPEGOWDA Et Al.

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“…Regarding the potential increased risk of VTE, one theorized mechanism is that testosterone induces polycythemia, which increases blood viscosity [3]. Interestingly, another recent nonrandomized single‐center open‐label registry study supports the possibility that longer duration testosterone replacement therapy (TRT) in testosterone deficient males may decrease the prevalence of anemia, improve lipid profiles, and may actually lower the overall risk for VTE [4]. When considering the effects of TRT administration, one must consider the overall need and goals of therapy, duration of treatment, and the patient's comorbidities.…”

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confidence: 99%