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患有睾酮缺乏症且有心血管疾病史的男性可从长期睾酮治疗中获益:一项登记研究的观察性、真实世界数据。

Men with testosterone deficiency and a history of cardiovascular diseases benefit from long-term testosterone therapy: observational, real-life data from a registry study.

作者信息

Haider Ahmad, Yassin Aksam, Haider Karim Sultan, Doros Gheorghe, Saad Farid, Rosano Giuseppe Mc

机构信息

Private Urology Practice, Bremerhaven, Germany.

Institute for Urology and Andrology, Segeberger Kliniken, Norderstedt, Germany; Department of Preventive Medicine, Men's Health Program, Dresden International University, Dresden, Germany; Department of Urology, Gulf Medical University, Ajman, United Arab Emirates.

出版信息

Vasc Health Risk Manag. 2016 Jun 14;12:251-61. doi: 10.2147/VHRM.S108947. eCollection 2016.

Abstract

BACKGROUND/OBJECTIVES: Long-term testosterone therapy (TTh) in men with hypogonadism has been shown to improve all components of the metabolic syndrome. In this study, we investigated the effects of long-term TTh up to 8 years in hypogonadal men with a history of cardiovascular disease (CVD).

PATIENTS AND METHODS

In two urological clinics observational registries, we identified 77 hypogonadal men receiving TTh who also had a history of CVD. The effects of TTh on anthropometric and metabolic parameters were investigated for a maximum duration of 8 years. Any occurrence of major adverse cardiovascular events was reported. All men received long-acting injections of testosterone undecanoate at 3-monthly intervals.

RESULTS

In 77 hypogonadal men with a history of CVD who received TTh, we observed a significant weight loss and a decrease in waist circumference and body mass index. Mean weight decreased from 114±13 kg to 91±9 kg, change from baseline: -24±1 kg and -20.2%±0.5%. Waist circumference decreased from 112±8 cm to 99±6 cm, change from baseline: -13±0.3 cm. Body mass index decreased from 37±4 to 29±3, change from baseline: -8±0.2 kg/m(2). Cardio-metabolic parameters such as lipid pattern, glycemic control, blood pressure, heart rate, and pulse pressure all improved significantly and sustainably. No patient suffered a major adverse cardiovascular event during the full observation time.

CONCLUSION

In men with hypogonadism, TTh appears to be effective in achieving sustained improvements in all cardiometabolic risk factors and may be effective as an add-on measure in the secondary prevention of cardiovascular events in hypogonadal men with a history of CVD.

摘要

背景/目的:已证实,对性腺功能减退男性进行长期睾酮治疗(TTh)可改善代谢综合征的所有组分。在本研究中,我们调查了对有心血管疾病(CVD)病史的性腺功能减退男性进行长达8年的长期TTh治疗的效果。

患者与方法

在两家泌尿外科诊所的观察性登记中,我们确定了77名接受TTh治疗且有CVD病史的性腺功能减退男性。研究了TTh对人体测量和代谢参数的影响,最长持续时间为8年。报告了任何重大不良心血管事件的发生情况。所有男性均接受每3个月一次的长效十一酸睾酮注射。

结果

在77名有CVD病史且接受TTh治疗的性腺功能减退男性中,我们观察到体重显著减轻,腰围和体重指数降低。平均体重从114±13千克降至91±9千克,与基线相比的变化为:-24±1千克,-20.2%±0.5%。腰围从112±8厘米降至99±6厘米,与基线相比的变化为:-13±0.3厘米。体重指数从37±4降至29±3,与基线相比的变化为:-8±0.2千克/米²。血脂谱、血糖控制、血压、心率和脉压等心脏代谢参数均显著且持续改善。在整个观察期内,没有患者发生重大不良心血管事件。

结论

对于性腺功能减退男性,TTh似乎能有效实现所有心脏代谢危险因素的持续改善,并且可能作为一种附加措施,对有CVD病史的性腺功能减退男性心血管事件的二级预防有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/95d5/4913536/43326dda3886/vhrm-12-251Fig1.jpg

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