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Testosterona e Reposicao Hormonal

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By Eduardo Roque Cardiologista com foco em cardiologia hospitalar e cuidados intensivos. Professor de clínica médica.
Panagiota Manolakou, Roxani Angelopoulou, Chris Bakoyiannis, Elias Bastounis
Cardiovascular disease incidence rates have long been known to significantly differ between the two sexes. Estrogens alone fail to explain this phenomenon, bringing an increasing amount of attention to the role of androgens. Contrary to what was initially hypothesized, androgens seem to have an overall cardioprotective effect, especially in men. Recent studies and published data continue to support this notion displaying a consistent inverse correlation with atherosclerosis progression and cardiovascular disease both in regressive and prospective study models...
May 12, 2009: Reproductive Biology and Endocrinology: RB&E
S S Signorelli, V Barresi, N Musso, M Anzaldi, E Croce, V Fiore, D F Condorelli
Although animal studies support the hypothesis that androgenic biological actions may affect experimental atherosclerosis progression, evidence for a relationship between androgen effects and peripheral arterial disease (PAD), a common clinical form of atherosclerosis, is weak or contradictory. Testosterone, the main androgen hormone, is converted in a 5alpha-reduced form by enzymatic activities in the target cells and some specific actions are mediated by such metabolites. Steroid 5-alpha reductase isoenzymes (SRD5A1 and SRD5A2) catalyze the conversion to the bioactive potent androgen dihydrotestosterone and other reduced metabolites and represent relevant regulators of local hormonal actions...
December 2008: Journal of Endocrinological Investigation
M R Adams, J K Williams, J R Kaplan
The factors responsible for the marked gender differences in risk of coronary heart disease and atherosclerosis severity remain largely undetermined. While some clinical and experimental evidence supports a protective effect of endogenous estrogen on the initiation and progression of atherosclerosis and incidence of coronary heart disease, much of the epidemiological data do not support this conclusion. The possibility that endogenous androgens may have adverse effects on atherosclerosis progression and coronary risk has received little attention...
May 1995: Arteriosclerosis, Thrombosis, and Vascular Biology
Atam B Singh, Stanley Hsia, Petar Alaupovic, Indrani Sinha-Hikim, Linda Woodhouse, Thomas A Buchanan, Ruoquing Shen, Rachelle Bross, Nancy Berman, Shalender Bhasin
The effects of T supplementation on insulin sensitivity, inflammation-sensitive markers, and apolipoproteins remain poorly understood. We do not know whether T's effects on plasma lipids, apolipoproteins, and insulin sensitivity are dose dependent, or whether significant anabolic effects can be achieved at T doses that do not adversely affect these cardiovascular risk factors. To determine the effects of different doses of T, 61 eugonadal men, 18-35 yr of age, were randomly assigned to 1 of 5 groups to receive monthly injections of long-acting GnRH agonist to suppress endogenous T secretion and weekly injections of 25, 50, 125, 300, or 600 mg T enanthate for 20 wk...
January 2002: Journal of Clinical Endocrinology and Metabolism
Samar R El Khoudary, Rachel P Wildman, Karen Matthews, Rebecca C Thurston, Joyce T Bromberger, Kim Sutton-Tyrrell
OBJECTIVE: To determine whether endogenous sex hormones (estradiol (E2), testosterone (T), sex hormone binding globulin (SHBG), and follicle stimulating hormone (FSH)) are longitudinally associated with progression of atherosclerosis among women at midlife. METHODS: 249 Pre- or early peri-menopausal women (42-57 years) from the Study of Women's Health Across the Nation (SWAN) were followed for up to 9 years (median = 3.7 years) and had up to 5 repeated measures of common carotid intima-media thickness (IMT) and adventitial diameter (AD)...
November 2012: Atherosclerosis
Adam R Poliwczak, Maja Tylińska, Marlena Broncel
INTRODUCTION:  Testosterone deficiency syndrome (TDS) is characterized by clinical signs of testosterone deficiency in men with reduced testosterone levels. It leads to endothelial dysfunction, which, apart from erectile dysfunction, accelerates atherosclerosis progression. OBJECTIVES:  The aim of the study was to evaluate the effect of testosterone supplementation in men with metabolic syndrome (MS) and TDS on autonomic balance assessed by heart rate variability (HRV) in 24‑hour Holter monitoring...
2013: Polskie Archiwum Medycyny Wewnętrznej
Shalender Bhasin
In spite of the widespread belief that testosterone supplementation increases the risk of atherosclerotic heart disease, evidence to support this premise is lacking. Although supraphysiological doses of testosterone, such as those used by athletes and recreational body builders, decrease plasma high-density lipoprotein (HDL) cholesterol concentrations, replacement doses of testosterone have had only a modest or no effect on plasma HDL in placebo-controlled trials. In epidemiological studies, serum total and free testosterone concentrations have been inversely correlated with intra-abdominal fat mass, risk of coronary artery disease, and type 2 diabetes mellitus...
2003: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Christian K Roberts, Brian H Chen, Sandeep Pruthi, Martin L Lee
Whether exogenous testosterone is proatherogenic remains controversial. We assessed the effects of graded doses of testosterone on serum markers of oxidative stress, chemotaxis, adhesion, and inflammation in healthy younger and older men. In a double-blind, randomized trial, 121 eugonadal men (n = 61, 18-35 years of age and n = 60, 60-75 years of age) were randomized to one of five groups to receive weekly injections of 25, 50, 125, 300, or 600 mg of testosterone enanthate for 20 wk, respectively, along with a long-acting gonadotropin-releasing hormone (GnRH) agonist...
January 15, 2014: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Jie Zhao, Chaoqiang Jiang, Tai Hing Lam, Bin Liu, Kar Keung Cheng, Lin Xu, Shiu Lun Au Yeung, Weisen Zhang, Gabriel M Leung, C Mary Schooling
BACKGROUND: Observationally lower testosterone is associated with an unhealthier cardiovascular (CVD) risk profile, but this association is open to confounding and reverse causality. The authors examined the association of testosterone with well-established cardiovascular disease (CVD) risk factors (blood pressure, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL)cholesterol and fasting glucose) and the Framingham score using a Mendelian randomization analysis with a separate-sample instrumental variable estimator...
February 2014: International Journal of Epidemiology
Emily J Gianatti, Philippe Dupuis, Rudolf Hoermann, Boyd J Strauss, John M Wentworth, Jeffrey D Zajac, Mathis Grossmann
OBJECTIVE: To determine whether testosterone therapy improves glucose metabolism in men with type 2 diabetes (T2D) and lowered testosterone. RESEARCH DESIGN AND METHODS: We conducted a randomized, double-blind, parallel, placebo-controlled trial in 88 men with T2D, aged 35-70 years with an HbA1c ≤8.5% (69 mmol/mol), and a total testosterone level, measured by immunoassay, of ≤12.0 nmol/L (346 ng/dL). Participants were randomly assigned to 40 weeks of intramuscular testosterone undecanoate (n = 45) or matching placebo (n = 43)...
August 2014: Diabetes Care
J Bradley Layton, Dongmei Li, Christoph R Meier, Julie L Sharpless, Til Stürmer, Susan S Jick, M Alan Brookhart
CONTEXT: New formulations, increased marketing, and wider recognition of declining testosterone levels in older age may have contributed to wider testosterone testing and supplementation in many countries. OBJECTIVE: Our objective was to describe testosterone testing and testosterone treatment in men in the United Kingdom and United States. DESIGN: This was a retrospective incident user cohort. SETTING: We evaluated commercial and Medicare insurance claims from the United States and general practitioner healthcare records from the United Kingdom for the years 2000 through 2011...
March 2014: Journal of Clinical Endocrinology and Metabolism
Shehzad Basaria, S Mitchell Harman, Thomas G Travison, Howard Hodis, Panayiotis Tsitouras, Matthew Budoff, Karol M Pencina, Joseph Vita, Connie Dzekov, Norman A Mazer, Andrea D Coviello, Philip E Knapp, Kathleen Hally, Emma Pinjic, Mingzhu Yan, Thomas W Storer, Shalender Bhasin
IMPORTANCE: Testosterone use in older men is increasing, but its long-term effects on progression of atherosclerosis are unknown. OBJECTIVE: To determine the effect of testosterone administration on subclinical atherosclerosis progression in older men with low or low-normal testosterone levels. DESIGN, SETTING, AND PARTICIPANTS: Testosterone's Effects on Atherosclerosis Progression in Aging Men (TEAAM) was a placebo-controlled, double-blind, parallel-group randomized trial involving 308 men 60 years or older with low or low-normal testosterone levels (100-400 ng/dL; free testosterone <50 pg/mL), recruited at 3 US centers...
August 11, 2015: JAMA: the Journal of the American Medical Association
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