Secondary Hypogonadism and Effects of Testosterone Replacement Therapy on Cardiovascular Events
Abstract
CONTEXT: The safety of testosterone replacement therapy (TRT) has generated some controversy during recent years. While untreated hypogonadism leads to diminished sexual characteristics, muscle weakness and osteoporosis, the cardiovascular safety of TRT has been vigorously debated. TRT remains the standard of care for those with secondary hypogonadism (SHG) due to structural pituitary disease, but long-term cardiovascular safety in this population remains unclear.
METHODS: We conducted a retrospective cohort study to investigate occurrence of major adverse cardiovascular events (MACE) in male patients with nonfunctioning pituitary adenomas and prolactinomas, with and without SHG. Demographic data, TRT treatment, stroke, myocardial infarction, and mortality data were retrieved from chart review as well as provincial cardiac and stroke registries.
RESULTS: There were 408 patients followed for a median 8.1 years (interquartile range 3.3-14.1); 150 (36.7%) did not have SHG, whereas 214 (52.5%) had SHG adequately treated with TRT and 44 (10.8%) had SHG that was untreated. Multivariable logistic regression analysis demonstrated no significant difference in MACE between groups. MACE outcomes were not impacted by size of adenoma, presence of other pituitary hormonal deficits, or testosterone levels. There was increased risk of mortality in untreated SHG compared to both TRT-treated SHG and those without SHG.
CONCLUSION: TRT does not appear to increase risk of MACE in those with SHG…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 408 participants or records.
Read the paper
Related studies
- Induced osteoblast differentiation by amide derivatives of stilbene: The possible osteogenic agents
- On model selections for repeated measurement data in clinical studies
- Regulation of GLUT transporters by flavonoids in androgen-sensitive and -insensitive prostate cancer cells
- Region-specific microRNA signatures in the human epididymis
- Synthesis, biological evaluation and molecular docking of 4-Amino-2H-benzo[h]chromen-2-one (ABO) analogs containing the piperazine moiety
- In Vitro characterization of the endocrine disrupting effects of per- and poly-fluoroalkyl substances (PFASs) on the human androgen receptor
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.