The DOI matches its Crossref record; 12 of the 12 references it cites were found in a registry or an index.
Lower Testosterone Levels Predict Incident Stroke and Transient Ischemic Attack in Older Men
Abstract
CONTEXT: Lower circulating testosterone concentrations are associated with metabolic syndrome, type 2 diabetes, carotid intima-media thickness, and aortic and lower limb arterial disease in men. However, it is unclear whether lower testosterone levels predict major cardiovascular events. OBJECTIVE: We examined whether lower serum testosterone was an independently significant risk factor for symptomatic cerebrovascular events in older men. DESIGN: This was a prospective observational study with median follow-up of 3.5 yr. SETTING: Community-dwelling, stroke-free older men were studied. PARTICIPANTS: A total of 3443 men at least 70 yr of age participated in the study. MAIN OUTCOME MEASURES: Baseline serum total testosterone, SHBG, and LH were assayed. Free testosterone was calculated using mass action equations. Incident stroke or transient ischemic attack (TIA) was recorded. RESULTS: A first stroke or TIA occurred in 119 men (3.5%). Total and free testosterone concentrations in the lowest quartiles (<11.7 nmol/liter and <222 pmol/liter) were associated with reduced event-free survival (P = 0.014 and P = 0.01, respectively). After adjustment including age, waist-hip ratio, waist circumference, smoking, hypertension, dyslipidemia, and medical comorbidity, lower total testosterone predicted increased incidence of stroke or TIA (hazard ratio = 1.99; 95% confidence interval, 1.33-2.99). Lower free testosterone was also associated (hazard ratio = 1.69; 95% confidence interval, 1.15-2.48), whereas SHBG and LH were not independently associated with incident stroke or TIA. CONCLUSIONS: In older men, lower total testosterone levels predict increased incidence of stroke or TIA after adjusting for conventional risk factors for cardiovascular disease. Men with low-normal testosterone levels had increased risk. Further studies are warranted to determine whether interventions that raise circulating testosterone levels might prevent cerebrovascular disease in men.
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Cites
A Critical Evaluation of Simple Methods for the Estimation of Free Testosterone in Serum
Vermeulen, A., Verdonck, L., & Kaufman, J. M. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.10.6079 · Cited by 3,824
Longitudinal Effects of Aging on Serum Total and Free Testosterone Levels in Healthy Men
Harman, S. M., Metter, E. J., Tobin, J. D., Pearson, J., & Blackman, M. R. (2001) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.86.2.7219 · Cited by 2,760
Feldman, H. A., Longcope, C., Derby, C. A., Johannes, C. B., Araujo, A. B., Coviello, A. D., Bremner, W. J., & McKinlay, J. B. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.2.8201 · Cited by 1,861
Rosner, W., Auchus, R. J., Azziz, R., Sluss, P. M., & Raff, H. (2007) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-1864 · Cited by 1,176 · cited 1×
“It should also be remembered that different testosterone assays may give varying results, and calculation of free testosterone may not provide an exact estimate of circulating free testosterone measured by equilibrium dialysis (34, 35).”
BackgroundInvestigation, treatment and monitoring of late-onset hypogonadism in males
Wang, C., Nieschlag, E., Swerdloff, R., Behre, H. M., Hellstrom, W. J., Gooren, L. J., Kaufman, J. M., Legros, J.-J., Lunenfeld, B., Morales, A., et al. (2008) · European Journal of Endocrinology · doi:10.1530/eje-08-0601 · Cited by 867
Low Serum Testosterone and Mortality in Older Men
Laughlin, G. A., Barrett-Connor, E., & Bergstrom, J. (2008) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2007-1792 · Cited by 798
Khaw, K.-T., Dowsett, M., Folkerd, E., Bingham, S., Wareham, N., Luben, R., Welch, A., & Day, N. (2007) · Circulation · doi:10.1161/circulationaha.107.719005 · Cited by 743
Malkin, C. J., Pugh, P. J., Jones, R. D., Kapoor, D., Channer, K. S., & Jones, T. H. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031069 · Cited by 731
Kupelian, V., Page, S. T., Araujo, A. B., Travison, T. G., Bremner, W. J., & McKinlay, J. B. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2005-1326 · Cited by 561
Endogenous sex hormones and cardiovascular disease incidence in men
Ärnlöv, J., Pencina, M. J., Amin, S., Nam, B.-H., Benjamin, E. J., Murabito, J. M., Wang, T. J., Knapp, P. E., D'Agostino, R. B., Bhasin, S., et al. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-145-3-200608010-00005 · Cited by 217
Cited by
Hypogonadism as a risk factor for cardiovascular mortality in men: a meta-analytic study
Corona, G., Rastrelli, G., Monami, M., Guay, A., Buvat, J., Sforza, A., Forti, G., Mannucci, E., & Maggi, M. (2011) · European Journal of Endocrinology · doi:10.1530/eje-11-0447 · Cited by 435
Update: Hypogonadotropic Hypogonadism in Type 2 Diabetes and Obesity
Dandona, P., & Dhindsa, S. (2011) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-2724 · Cited by 313
Genetic determinants of serum testosterone concentrations in men
Ohlsson, C., Wallaschofski, H., Lunetta, K. L., Stolk, L., Perry, J. R. B., Koster, A., Petersen, A.-K., Eriksson, J., Lehtimäki, T., Huhtaniemi, I. T., et al. (2011) · PLoS Genetics · doi:10.1371/journal.pgen.1002313 · Cited by 224
Endocrine Aspects of Male Sexual Dysfunctions
Buvat, J., Maggi, M., Gooren, L., Guay, A. T., Kaufman, J., Morgentaler, A., Schulman, C., Tan, H. M., Torres, L. O., Yassin, A., et al. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.01780.x · Cited by 221
Saboor Aftab, S. A., Kumar, S., & Barber, T. M. (2013) · Clinical Endocrinology · doi:10.1111/cen.12092 · Cited by 157
Metadata
- Authors
- Yeap, B. B., Hyde, Z., Almeida, O. P., Norman, P. E., Chubb, S. A. P., Jamrozik, K., Flicker, L., & Hankey, G. J.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2009-07-01
- Volume
- 94
- Issue
- 7
- Pages
- 2353-2359
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2099276252
- Cited by
- 275
- References
- 12
- FWCI
- 18.48
- Type
- journal article
- Language
- en
- Open access
- closed
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