睾酮缺乏症和心血管疾病死亡率
Testosterone deficiency and cardiovascular mortality作者机构：Men's Health Boston Harvard Medical School Boston MA USA.
出 版 物：《Asian Journal of Andrology》 (亚洲男性学杂志（英文版）)
年 卷 期：2015年第17卷第1期
页 面：26-31,I0007页
核心收录：
基 金：Monica Caliber expertly assisted with manuscript preparation
主 题：cardiovascular mortality myocardial infarction risk stroke testosterone
摘 要：New concerns have been raised regarding cardiovascular （CV） risks with testosterone （T） therapy （TTh）. These concerns are based primarily on two widely reported retrospective studies. However, methodological flaws and data errors invalidate both studies as credible evidence of risk. One showed reduced adverse events by half in T-treated men but reversed this result using an unproven statistical approach. The authors subsequently acknowledged serious data errors including nearly 10% contamination of the dataset by women. The second study mistakenly used the rate of T prescriptions written by healthcare providers to men with recent myocardial infarction （MI） as a proxy for the naturally occurring rate of Mh Numerous studies suggest T is beneficial, including decreased mortality in association with TTh, reduced MI rate with TTh in men with the greatest MI risk prognosis, and reduced CV and overall mortality with higher serum levels of endogenous T. Randomized controlled trials have demonstrated benefits of TTh in men with coronary artery disease and congestive heart failure. Improvement in CV risk factors such as fat mass and glycemic control have been repeatedly demonstrated in T-deficient men treated with T. The current evidence does not support the belief that TTh is associated with increased CV risk or CV mortality. On the contrary, a wealth of evidence accumulated over several decades suggests that low serum T levels are associated with increased risk and that higher endogenous T, as well as TTh itself, appear to be beneficial for CV mortality and risk.
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