de Almeida Ferreira Maurício, Mendonça José Alexandre
Cardiologist Specialist, Clínica Academia, Americana, São Paulo, Brazil.
Health Sciences Post-graduate program, Pontifícia Universidade Católica de Campinas, Campinas, Brazil.
Drugs Context. 2022 Feb 2;11. doi: 10.7573/dic.2021-8-12. eCollection 2022.
Testosterone replacement therapy (TRT) is one of the main lines of treatment for men with hypogonadism. This study sought to evaluate the influence of TRT in men with late-onset hypogonadism (LOH), regarding fatigue, coronary artery disease (CAD), carotid intima-media thickness (CIMT) and cardiovascular risk.
This study compared men with LOH already on TRT for >1 year to newly diagnosed men with LOH who recently started TRT (controls). We included men aged >18 years with clinical manifestations of testosterone deficiency and testosterone levels of <300 ng/dL documented in two separate occasions.
A total of 33 patients were included in the study group and 30 in the control group. Mean age was 49.1 years (±11.5) in those already under TRT for >1 year and 45 (±12.2) years in the control group (=0.18). CAD was present in 14 (46.7%) patients in the control group and in 3 (9.1%) in the study group (<0.001). TRT >1 year was not associated with lower rates of CAD in multivariable analysis. Fatigue Severity Score was significantly higher in the control group (39.2±15.0), compared to TRT >1 year (23.5±8.1; <0.001). In a multivariable analysis adjusted for age and hypertension, TRT >1 year was associated with a 14.8-point decrease in Fatigue Severity Score (<0.001). Overall, there were no differences between the study group and the control group regarding cardiovascular risk (=0.31).
TRT for >1 year was associated with significantly lower fatigue scores. No differences were observed regarding CIMT, CAD and cardiovascular risk according to the WHO-ISH scale.
睾酮替代疗法（TRT）是性腺功能减退男性的主要治疗方法之一。本研究旨在评估TRT对迟发性性腺功能减退（LOH）男性在疲劳、冠状动脉疾病（CAD）、颈动脉内膜中层厚度（CIMT）和心血管风险方面的影响。
本研究将已接受TRT超过1年的LOH男性与新诊断且最近开始TRT的LOH男性（对照组）进行比较。我们纳入了年龄大于18岁、有睾酮缺乏临床表现且两次独立检测睾酮水平均<300 ng/dL的男性。
研究组共纳入33例患者，对照组纳入30例。接受TRT超过1年的患者平均年龄为49.1岁（±11.5），对照组为45岁（±12.2）（P=0.18）。对照组中有14例（46.7%）患者存在CAD，研究组中有3例（9.1%）（P<0.001）。在多变量分析中，TRT超过1年与CAD发生率较低无关。与接受TRT超过1年的患者（23.5±8.1）相比，对照组的疲劳严重程度评分显著更高（39.2±15.0）（P<0.001）。在对年龄和高血压进行校正的多变量分析中，TRT超过1年与疲劳严重程度评分降低14.8分相关（P<0.001）。总体而言，研究组和对照组在心血管风险方面无差异（P=0.31）。
TRT超过1年与显著更低的疲劳评分相关。根据世界卫生组织-国际高血压学会（WHO-ISH）标准，在CIMT、CAD和心血管风险方面未观察到差异。
