Effect of treatment with testosterone on endothelial function in hypogonadal men: a systematic review and meta-analysis
Despite several studies showing an inverse correlation of total testosterone with endothelial damage, the effect of testosterone replacement therapy (TTh) on endothelial function has been scarcely investigated. In order to systematically assess the relationship between endothelial dysfunction and TT...
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| Veröffentlicht in: | International journal of impotence research 2020-07, Vol.32 (4), p.379-386 |
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| creator | Sansone, Andrea Rastrelli, Giulia Cignarelli, Angelo de Rocco Ponce, Maurizio Condorelli, Rosita Angela Giannetta, Elisa Maseroli, Elisa Pinto, Sara Salzano, Ciro Santi, Daniele |
| description | Despite several studies showing an inverse correlation of total testosterone with endothelial damage, the effect of testosterone replacement therapy (TTh) on endothelial function has been scarcely investigated. In order to systematically assess the relationship between endothelial dysfunction and TTh, we performed a review and meta-analysis of available prospective and cross-sectional studies. A thorough research was performed on MEDLINE for hypogonadism and endothelial dysfunction. We retrieved 28 papers, among which 23 were excluded for different reasons: five papers accounting for six studies (two crossover randomized clinical trial (RCT), three observational, one placebo controlled RCT) were therefore included in analysis. Overall, 86 patients with hypogonadism were included in analysis (mean age 49.57 ± 8.85 years). Baseline total testosterone serum levels were 8.11 ± 2.42 nmol/L and significantly increased while undergoing TTh (standard mean difference (SMD) 2.93 nmol/L, 95% confidence interval (CI) 1.89:3.97,
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| doi_str_mv | 10.1038/s41443-019-0163-6 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2246906152</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A629421675</galeid><sourcerecordid>A629421675</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-3fc253fbea088e8eada1d0cab16d80dc1a8776f5c4f475bd33e41c48f9f488793</originalsourceid><addsrcrecordid>eNp1kt-L1DAQx4so3nr6B_giAUF86Zk0aZv4dhznDzjwRZ9DNp1sc7TJmqQu-987Zc_TEyWEwMznO5kZvlX1ktELRrl8lwUTgteUKbwdr7tH1YaJvqtbIdXjakNV29ZKcXpWPcv5llKqkHtanXHW8FYquakO186BLSQ6UhKYMkMo5ODLSArkEnOBFAOQGAiEIZYRJm8m4pZgi8egD2Q87uMuBjNgHNXviSH5iLrZFG9Jgh8eDsSEAZPF1CaY6Zh9fl49cWbK8OLuPa--fbj-evWpvvny8fPV5U1tRU9LzZ1tWu62YKiUIAF_YQO1Zsu6QdLBMiP7vnOtFU707XbgHASzQjrlhJS94ufV21PdfYrfFxxJzz5bmCYTIC5ZN43oFO1Y2yD6-i_0Ni4J-0VKNJzzXuCS76mdmUD74GJJxq5F9WXXKNGwrm-RuvgHhWeA2VvcqPMYfyB484dgBDOVMcdpWbecH4LsBNoUc07g9D752aSjZlSvrtAnV2h0hV5dodeeX91NtmxnGO4Vv2yAQHMCMqbCDtLv0f9f9ScEiMHQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2423337416</pqid></control><display><type>article</type><title>Effect of treatment with testosterone on endothelial function in hypogonadal men: a systematic review and meta-analysis</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Sansone, Andrea ; Rastrelli, Giulia ; Cignarelli, Angelo ; de Rocco Ponce, Maurizio ; Condorelli, Rosita Angela ; Giannetta, Elisa ; Maseroli, Elisa ; Pinto, Sara ; Salzano, Ciro ; Santi, Daniele</creator><creatorcontrib>Sansone, Andrea ; Rastrelli, Giulia ; Cignarelli, Angelo ; de Rocco Ponce, Maurizio ; Condorelli, Rosita Angela ; Giannetta, Elisa ; Maseroli, Elisa ; Pinto, Sara ; Salzano, Ciro ; Santi, Daniele</creatorcontrib><description>Despite several studies showing an inverse correlation of total testosterone with endothelial damage, the effect of testosterone replacement therapy (TTh) on endothelial function has been scarcely investigated. In order to systematically assess the relationship between endothelial dysfunction and TTh, we performed a review and meta-analysis of available prospective and cross-sectional studies. A thorough research was performed on MEDLINE for hypogonadism and endothelial dysfunction. We retrieved 28 papers, among which 23 were excluded for different reasons: five papers accounting for six studies (two crossover randomized clinical trial (RCT), three observational, one placebo controlled RCT) were therefore included in analysis. Overall, 86 patients with hypogonadism were included in analysis (mean age 49.57 ± 8.85 years). Baseline total testosterone serum levels were 8.11 ± 2.42 nmol/L and significantly increased while undergoing TTh (standard mean difference (SMD) 2.93 nmol/L, 95% confidence interval (CI) 1.89:3.97,
p
< 0.001). Due to the paucity of studies available, flow-mediated dilation (FMD) was chosen as the best surrogate marker of endothelial dysfunction. FMD did not significantly change after testosterone administration (SMD −0.22, 95% CI −1.29:0.84,
I
2
= 90%); acute testosterone administration was associated with an increase in FMD, whereas a reduction in FMD emerged following chronic treatment, but statistical significance was not reached for both effects. This is the first meta-analysis study assessing the influence of TTh on endothelial function; however, results are far from conclusive, as proven by the high heterogeneity.</description><identifier>ISSN: 0955-9930</identifier><identifier>EISSN: 1476-5489</identifier><identifier>DOI: 10.1038/s41443-019-0163-6</identifier><identifier>PMID: 31235898</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/499 ; 692/699/317 ; 692/699/75 ; Adult ; Cross-Sectional Studies ; Drug therapy ; Endothelium ; Health aspects ; Hormone Replacement Therapy ; Humans ; Hypogonadism ; Hypogonadism - drug therapy ; Male ; Medicine ; Medicine & Public Health ; Mens health ; Meta-analysis ; Middle Aged ; Patient outcomes ; Physiological aspects ; Prospective Studies ; Reproductive Medicine ; Review Article ; rology ; Sexual disorders ; Systematic review ; Testosterone ; Testosterone - therapeutic use ; Urology ; Vascular endothelium ; Veins & arteries</subject><ispartof>International journal of impotence research, 2020-07, Vol.32 (4), p.379-386</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Limited 2019</rights><rights>COPYRIGHT 2020 Nature Publishing Group</rights><rights>The Author(s), under exclusive licence to Springer Nature Limited 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-3fc253fbea088e8eada1d0cab16d80dc1a8776f5c4f475bd33e41c48f9f488793</citedby><cites>FETCH-LOGICAL-c470t-3fc253fbea088e8eada1d0cab16d80dc1a8776f5c4f475bd33e41c48f9f488793</cites><orcidid>0000-0002-1210-2843 ; 0000-0002-6164-4278</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31235898$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sansone, Andrea</creatorcontrib><creatorcontrib>Rastrelli, Giulia</creatorcontrib><creatorcontrib>Cignarelli, Angelo</creatorcontrib><creatorcontrib>de Rocco Ponce, Maurizio</creatorcontrib><creatorcontrib>Condorelli, Rosita Angela</creatorcontrib><creatorcontrib>Giannetta, Elisa</creatorcontrib><creatorcontrib>Maseroli, Elisa</creatorcontrib><creatorcontrib>Pinto, Sara</creatorcontrib><creatorcontrib>Salzano, Ciro</creatorcontrib><creatorcontrib>Santi, Daniele</creatorcontrib><title>Effect of treatment with testosterone on endothelial function in hypogonadal men: a systematic review and meta-analysis</title><title>International journal of impotence research</title><addtitle>Int J Impot Res</addtitle><addtitle>Int J Impot Res</addtitle><description>Despite several studies showing an inverse correlation of total testosterone with endothelial damage, the effect of testosterone replacement therapy (TTh) on endothelial function has been scarcely investigated. In order to systematically assess the relationship between endothelial dysfunction and TTh, we performed a review and meta-analysis of available prospective and cross-sectional studies. A thorough research was performed on MEDLINE for hypogonadism and endothelial dysfunction. We retrieved 28 papers, among which 23 were excluded for different reasons: five papers accounting for six studies (two crossover randomized clinical trial (RCT), three observational, one placebo controlled RCT) were therefore included in analysis. Overall, 86 patients with hypogonadism were included in analysis (mean age 49.57 ± 8.85 years). Baseline total testosterone serum levels were 8.11 ± 2.42 nmol/L and significantly increased while undergoing TTh (standard mean difference (SMD) 2.93 nmol/L, 95% confidence interval (CI) 1.89:3.97,
p
< 0.001). Due to the paucity of studies available, flow-mediated dilation (FMD) was chosen as the best surrogate marker of endothelial dysfunction. FMD did not significantly change after testosterone administration (SMD −0.22, 95% CI −1.29:0.84,
I
2
= 90%); acute testosterone administration was associated with an increase in FMD, whereas a reduction in FMD emerged following chronic treatment, but statistical significance was not reached for both effects. This is the first meta-analysis study assessing the influence of TTh on endothelial function; however, results are far from conclusive, as proven by the high heterogeneity.</description><subject>692/499</subject><subject>692/699/317</subject><subject>692/699/75</subject><subject>Adult</subject><subject>Cross-Sectional Studies</subject><subject>Drug therapy</subject><subject>Endothelium</subject><subject>Health aspects</subject><subject>Hormone Replacement Therapy</subject><subject>Humans</subject><subject>Hypogonadism</subject><subject>Hypogonadism - drug therapy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mens health</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>Patient outcomes</subject><subject>Physiological aspects</subject><subject>Prospective Studies</subject><subject>Reproductive Medicine</subject><subject>Review Article</subject><subject>rology</subject><subject>Sexual disorders</subject><subject>Systematic review</subject><subject>Testosterone</subject><subject>Testosterone - therapeutic use</subject><subject>Urology</subject><subject>Vascular endothelium</subject><subject>Veins & arteries</subject><issn>0955-9930</issn><issn>1476-5489</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kt-L1DAQx4so3nr6B_giAUF86Zk0aZv4dhznDzjwRZ9DNp1sc7TJmqQu-987Zc_TEyWEwMznO5kZvlX1ktELRrl8lwUTgteUKbwdr7tH1YaJvqtbIdXjakNV29ZKcXpWPcv5llKqkHtanXHW8FYquakO186BLSQ6UhKYMkMo5ODLSArkEnOBFAOQGAiEIZYRJm8m4pZgi8egD2Q87uMuBjNgHNXviSH5iLrZFG9Jgh8eDsSEAZPF1CaY6Zh9fl49cWbK8OLuPa--fbj-evWpvvny8fPV5U1tRU9LzZ1tWu62YKiUIAF_YQO1Zsu6QdLBMiP7vnOtFU707XbgHASzQjrlhJS94ufV21PdfYrfFxxJzz5bmCYTIC5ZN43oFO1Y2yD6-i_0Ni4J-0VKNJzzXuCS76mdmUD74GJJxq5F9WXXKNGwrm-RuvgHhWeA2VvcqPMYfyB484dgBDOVMcdpWbecH4LsBNoUc07g9D752aSjZlSvrtAnV2h0hV5dodeeX91NtmxnGO4Vv2yAQHMCMqbCDtLv0f9f9ScEiMHQ</recordid><startdate>20200701</startdate><enddate>20200701</enddate><creator>Sansone, Andrea</creator><creator>Rastrelli, Giulia</creator><creator>Cignarelli, Angelo</creator><creator>de Rocco Ponce, Maurizio</creator><creator>Condorelli, Rosita Angela</creator><creator>Giannetta, Elisa</creator><creator>Maseroli, Elisa</creator><creator>Pinto, Sara</creator><creator>Salzano, Ciro</creator><creator>Santi, Daniele</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1210-2843</orcidid><orcidid>https://orcid.org/0000-0002-6164-4278</orcidid></search><sort><creationdate>20200701</creationdate><title>Effect of treatment with testosterone on endothelial function in hypogonadal men: a systematic review and meta-analysis</title><author>Sansone, Andrea ; 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In order to systematically assess the relationship between endothelial dysfunction and TTh, we performed a review and meta-analysis of available prospective and cross-sectional studies. A thorough research was performed on MEDLINE for hypogonadism and endothelial dysfunction. We retrieved 28 papers, among which 23 were excluded for different reasons: five papers accounting for six studies (two crossover randomized clinical trial (RCT), three observational, one placebo controlled RCT) were therefore included in analysis. Overall, 86 patients with hypogonadism were included in analysis (mean age 49.57 ± 8.85 years). Baseline total testosterone serum levels were 8.11 ± 2.42 nmol/L and significantly increased while undergoing TTh (standard mean difference (SMD) 2.93 nmol/L, 95% confidence interval (CI) 1.89:3.97,
p
< 0.001). Due to the paucity of studies available, flow-mediated dilation (FMD) was chosen as the best surrogate marker of endothelial dysfunction. FMD did not significantly change after testosterone administration (SMD −0.22, 95% CI −1.29:0.84,
I
2
= 90%); acute testosterone administration was associated with an increase in FMD, whereas a reduction in FMD emerged following chronic treatment, but statistical significance was not reached for both effects. This is the first meta-analysis study assessing the influence of TTh on endothelial function; however, results are far from conclusive, as proven by the high heterogeneity.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>31235898</pmid><doi>10.1038/s41443-019-0163-6</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-1210-2843</orcidid><orcidid>https://orcid.org/0000-0002-6164-4278</orcidid></addata></record> |
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| subjects | 692/499 692/699/317 692/699/75 Adult Cross-Sectional Studies Drug therapy Endothelium Health aspects Hormone Replacement Therapy Humans Hypogonadism Hypogonadism - drug therapy Male Medicine Medicine & Public Health Mens health Meta-analysis Middle Aged Patient outcomes Physiological aspects Prospective Studies Reproductive Medicine Review Article rology Sexual disorders Systematic review Testosterone Testosterone - therapeutic use Urology Vascular endothelium Veins & arteries |
| title | Effect of treatment with testosterone on endothelial function in hypogonadal men: a systematic review and meta-analysis |
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