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Hypertension, dyslipidemia and overweight are related to lower testosterone levels in a cohort of men undergoing prostate biopsy

International Journal of Impotence Research volume 24, pages 110–113 (2012)Cite this article

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Abstract

Testosterone deficiency syndrome (TDS) is a clinical and biochemical entity related to sexual and cardiovascular health. Hypertension, diabetes mellitus (DM), dyslipidemia and overweight are four clinical factors strongly related to cardiovascular illnesses. The aim of our study was to determine if the presence and number of cardiovascular risk factors was related to total testosterone levels and the presence of biochemical TDS. We retrospectively analyzed 384 patients referred to our center for prostate biopsy between September 2007 and December 2009. Variables age, height, weight, body mass index (BMI), tobacco use, alcohol intake, hypertension, DM, dyslipidemia (hypercholesterolemia/hypertriglyceridemia) and overweight (BMI>25) were recorded prospectively. Hormonal profile was determined as part of our clinical protocol. We used 231 and 346 ng dl−1 as total testosterone cut-points (8–12 nmol l−1) for diagnosis of biochemical TDS, following ISA-ISSAM-EAU Guidelines. We analyzed the relationship between testosterone levels and the presence of hypertension, DM, dyslipidemia and overweight, and with the number of these cardiovascular risk factors. Mean age was 66±8 years. Prevalence of TDS was 6.5% within the 231 ng ml−1 cutoff point and 28.4% for the 346 ng dl−1 cutoff point. Levels of testosterone were related to hypertension (P=0.007), dyslipidemia (P=0.013), overweight (P=0.036) and the number of cardiovascular risk factors (P=0.018). The prevalence of TDS in our population is comparable to data from international studies. Testosterone levels decrease as the number of cardiovascular risk factors rise.

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References

  1. Wu FC, Tajar A, Beynon JM, Pye SR, Silman AJ, Finn JD, et al. EMAS Group. Identification of late-onset hypogonadism in middle-aged and elderly men. N Engl J Med 2010; 363: 123–135.

    Article  CAS  Google Scholar 

  2. Gray A, Feldman HA, McKinlay JB . Age, disease, and changing sex hormone levels in middle-aged men: results of the Massachusetts Male Aging Study. J Clin Endocrinol Metab 1991; 73: 1016.

    Article  CAS  Google Scholar 

  3. Feldman HA, Longcope C, Derby CA, Johannes CB, Araujo AB, Coviello AD et al. Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts Male Aging Study. J Clin Endocrinol Metab 2002; 87: 589–598.

    CAS  Google Scholar 

  4. Wang C, Nieschlag E, Swerdloff R . Investigation, treatment, and monitoring of late-onset hypogonadism in males: ISA, ISSAM, EAU, EAA, and ASA recommendations. Eur Urol 2009; 55: 121.

    Article  Google Scholar 

  5. Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Hatzichristou D, Montorsi F et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol 2010; 57: 804–814.

    Article  Google Scholar 

  6. Traish AM, Saad F, Feeley RJ, Guay A . The dark side of testosterone deficiency: III. Cardiovascular disease. J Androl 2009; 30: 477–494.

    Article  CAS  Google Scholar 

  7. Traish AM, Saad F, Guay A . The dark side of testosterone deficiency: II. Type 2 diabetes and insulin resistance. J Androl 2009; 30: 23–32.

    Article  CAS  Google Scholar 

  8. Traish AM, Guay A, Feeley R, Saad F . The dark side of testosterone deficiency: I. Metabolic syndrome and erectile dysfunction. J Androl 2009; 30: 10–22.

    Article  CAS  Google Scholar 

  9. Shores MM, Matsumoto AM, Sloan KL, Kivlahan DR . Low serum testosterone and mortality in male veterans. Arch Intern Med 2006; 166: 1660–1665.

    Article  CAS  Google Scholar 

  10. Corona G, Monami M, Rastrelli G, Aversa A, Tishova Y, Saad F et al. Testosterone and metabolic syndrome: a meta-analysis study. J Sex Med 2011; 8: 272–283.

    Article  CAS  Google Scholar 

  11. Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 2009; 120: 1640–1645.

    Article  CAS  Google Scholar 

  12. Basaria S . Androgen deprivation therapy, insulin resistance, and cardiovascular mortality: an inconvenient truth. J Androl 2008; 29: 534–539.

    Article  Google Scholar 

  13. Zitzmann M . Testosterone deficiency, insulin resistance and the metabolic syndrome. Nat Rev Endocrinol 2009; 5: 673–681.

    Article  CAS  Google Scholar 

  14. Taskinen MR . Is metabolic syndrome the main threat to human health in the twenty-first century? Arterioscler Thromb Vasc Biol 2007; 27: 2275.

    Article  CAS  Google Scholar 

  15. Martínez-Jabaloyas. Comorbidities in men with erectile dysfunction with and without hypogonadism. JMH 2010; 7: 303–304.

    Google Scholar 

  16. Kaplan SA, Meehan AG, Shah A . The age related decrease in testosterone is significantly exacerbated in obese men with the metabolic syndrome. What are the implications for the relatively high incidence of erectile dysfunction observed in these men? J Urol 2006; 176: 1524–1528.

    Article  CAS  Google Scholar 

  17. Pitteloud N, Mootha VK, Dwyer AA, Hardin M, Lee H, Eriksson KF et al. Relationship between testosterone levels, insulin sensitivity, and mitochondrial function in men. Diabetes Care 2005; 28: 1636–1642.

    Article  CAS  Google Scholar 

  18. Pasquali R, Casimirri F, De Iasio R, Mesini P, Boschi S, Chierici R et al. Insulin regulates testosterone and sex hormone-binding globulin concentrations in adult normal weight and obese men. J Clin Endocrinol Metab 1995; 80: 654–658.

    CAS  PubMed  Google Scholar 

  19. Isidori AM, Giannetta E, Greco EA, Gianfrilli D, Bonifacio V, Isidori A et al. Effects of testosterone on body composition, bone metabolism and serum lipid profile in middle-aged men: a meta-analysis. Clin Endocrinol (Oxf) 2005; 63: 280–293.

    Article  CAS  Google Scholar 

  20. Corona G, Mannucci E, Petrone L, Schulman C, Balercia G, Fisher AD et al. A comparison of NCEP- ATPIII and IDF metabolic syndrome definitions with relation to metabolic syndrome-associated sexual dysfunction. J Sex Med 2007a; 4: 789–796.

    Article  Google Scholar 

  21. Hughes GS, Mathur RS, Margolius HS . Sex steroid hormones are altered in essential hypertension. J Hypertens 1989; 7: 181–187.

    Article  CAS  Google Scholar 

  22. Labropoulos B, Velonakis E, Oekonomakos P, Laskaris J, Katsimades D . Serum sex hormones in patients with coronary disease and their relationship to known factors causing atherosclerosis. Cardiology 1982; 69: 98–103.

    Article  CAS  Google Scholar 

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Acknowledgements

We thank Nizam Mamode, MD PhD from Guy's and St Thomas’, and Andrea Sallent for reviewing of the manuscript.

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Authors and Affiliations

  1. Urology Department, Hospital Clinic Barcelona, Barcelona, Spain

    E Garcia-Cruz, M Piqueras, J Huguet, M Perez-Marquez, D Gosalbez, L Peri, L Izquierdo, P Luque, M J Ribal & A Alcaraz

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  1. E Garcia-Cruz
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  2. M Piqueras
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Correspondence to E Garcia-Cruz.

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Garcia-Cruz, E., Piqueras, M., Huguet, J. et al. Hypertension, dyslipidemia and overweight are related to lower testosterone levels in a cohort of men undergoing prostate biopsy. Int J Impot Res 24, 110–113 (2012). https://doi.org/10.1038/ijir.2011.55

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  • DOI: https://doi.org/10.1038/ijir.2011.55

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