Department of Biochemistry, University of Mississippi Medical Center, Jackson, MS.
Department of Women's Health Research Center, University of Mississippi Medical Center, Jackson, MS.
J Am Heart Assoc. 2017 Oct 17;6(10):e007074. doi: 10.1161/JAHA.117.007074.
The safety of testosterone supplements in men remains unclear. In the present study, we tested the hypothesis that in young and old male spontaneously hypertensive rats (SHR), long-term testosterone supplements increase blood pressure and that the mechanism is mediated in part by activation of the renin-angiotensin system.
In untreated males, serum testosterone exhibited a sustained decrease after 5 months of age, reaching a nadir by 18 to 22 months of age. The reductions in serum testosterone were accompanied by an increase in body weight until very old age (18 months). Testosterone supplements were given for 6 weeks to young (12 weeks-YMSHR) and old (21-22 months-OMSHR) male SHR that increased serum testosterone by 2-fold in young males and by 4-fold in old males. Testosterone supplements decreased body weight, fat mass, lean mass, and plasma leptin, and increased plasma estradiol in YMSHR but had no effect in OMSHR. Mean arterial pressure (MAP) was significantly higher in OMSHR than in YMSHR and testosterone supplements decreased MAP in OMSHR, but significantly increased MAP in YMSHR. Enalapril, the angiotensin-converting enzyme inhibitor, reduced MAP in both control and testosterone-supplemented YMSHR, but had a greater effect on MAP in testosterone-treated rats, suggesting the mechanism responsible for the increase in MAP in YMSHR is mediated at least in part by activation of the renin-angiotensin system.
Taken together with previous studies, these data suggest that testosterone supplements may have differential effects on men depending on age, cardiovascular and metabolic status, and dose and whether given long-term or short-term.
目前,关于男性补充睾酮的安全性仍不明确。在本研究中,我们检验了以下假说:在年轻和年老的自发性高血压大鼠(SHR)中,长期补充睾酮会导致血压升高,而这种机制部分是通过肾素-血管紧张素系统的激活介导的。
在未经治疗的雄性大鼠中,血清睾酮在 5 月龄后持续下降,18 至 22 月龄时达到最低点。血清睾酮的降低伴随着体重的增加,直到非常老的年龄(18 月龄)。我们给予年轻(12 周龄-YMSHR)和年老(21-22 月龄-OMSHR)雄性 SHR 为期 6 周的睾酮补充治疗,使年轻雄性大鼠的血清睾酮增加 2 倍,年老雄性大鼠的血清睾酮增加 4 倍。睾酮补充治疗降低了 YMSHR 的体重、脂肪量、瘦体量和血浆瘦素水平,并增加了血浆雌二醇水平,但对 OMSHR 无影响。平均动脉压(MAP)在 OMSHR 中明显高于 YMSHR,而睾酮补充治疗降低了 OMSHR 的 MAP,但显著增加了 YMSHR 的 MAP。血管紧张素转换酶抑制剂依那普利降低了对照组和睾酮补充 YMSHR 的 MAP,但对睾酮处理大鼠的 MAP 影响更大,提示导致 YMSHR 中 MAP 升高的机制至少部分是通过肾素-血管紧张素系统的激活介导的。
综合以往的研究结果,这些数据表明,睾酮补充治疗可能会根据年龄、心血管和代谢状态以及剂量和长期或短期给予而对男性产生不同的影响。