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Endogenous testosterone, endothelial dysfunction, and cardiovascular events in men with nondialysis chronic kidney disease.
Clin J Am Soc Nephrol. 2011 Jul; 6(7):1617-25.CJ

Abstract

BACKGROUND AND OBJECTIVES

Deterioration of kidney function impairs testosterone production, with hypogonadism being common in men with chronic kidney disease (CKD). In nonrenal populations, testosterone is suggested to participate in the atherosclerotic process. In male dialysis patients, we showed that low testosterone increases the risk of mortality. We here studied plausible links among testosterone levels, vascular derangements, and cardiovascular events in nondialysis CKD men.

DESIGN, SETTING, PARTICIPANTS, & METHODS

This was a cross-sectional analysis in which flow-mediated dilation (FMD) was assessed in 239 CKD male patients (stages 1 to 5; mean age 52 ± 12 years), together with routine measurements, serum total and free testosterone, and follow-up for cardiovascular outcomes.

RESULTS

Total and free testosterone levels decreased in parallel with the reduction of kidney function. Multiple regression analyses showed that total and free testosterone significantly and independently contributed to explain the variance of FMD. After a median follow-up of 31 months (range 8 to 35 months), 22 fatal and 50 nonfatal cardiovascular events occurred. In Cox analysis, the risk of cardiovascular events was reduced by 22% for each nanomole-per-liter increment of total testosterone. This reduced risk persisted after adjustment for age, renal function, diabetes mellitus, previous cardiovascular history, C-reactive protein, albumin, and FMD. The same was true for free testosterone concentrations.

CONCLUSIONS

The reduction in endogenous testosterone levels observed with progressive CKD was inversely associated with endothelial dysfunction and exacerbated the risk of future cardiovascular events in nondialysis male CKD patients.

Authors+Show Affiliations

Department Nephrology, School of Medicine, Ankara, Turkey. Juan.jesus.carrero@ki.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21700826

Citation

Yilmaz, Mahmut Ilker, et al. "Endogenous Testosterone, Endothelial Dysfunction, and Cardiovascular Events in Men With Nondialysis Chronic Kidney Disease." Clinical Journal of the American Society of Nephrology : CJASN, vol. 6, no. 7, 2011, pp. 1617-25.
Yilmaz MI, Sonmez A, Qureshi AR, et al. Endogenous testosterone, endothelial dysfunction, and cardiovascular events in men with nondialysis chronic kidney disease. Clin J Am Soc Nephrol. 2011;6(7):1617-25.
Yilmaz, M. I., Sonmez, A., Qureshi, A. R., Saglam, M., Stenvinkel, P., Yaman, H., Eyileten, T., Caglar, K., Oguz, Y., Taslipinar, A., Vural, A., Gok, M., Unal, H. U., Yenicesu, M., & Carrero, J. J. (2011). Endogenous testosterone, endothelial dysfunction, and cardiovascular events in men with nondialysis chronic kidney disease. Clinical Journal of the American Society of Nephrology : CJASN, 6(7), 1617-25. https://doi.org/10.2215/CJN.10681210
Yilmaz MI, et al. Endogenous Testosterone, Endothelial Dysfunction, and Cardiovascular Events in Men With Nondialysis Chronic Kidney Disease. Clin J Am Soc Nephrol. 2011;6(7):1617-25. PubMed PMID: 21700826.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endogenous testosterone, endothelial dysfunction, and cardiovascular events in men with nondialysis chronic kidney disease. AU - Yilmaz,Mahmut Ilker, AU - Sonmez,Alper, AU - Qureshi,Abdul Rashid, AU - Saglam,Mutlu, AU - Stenvinkel,Peter, AU - Yaman,Halil, AU - Eyileten,Tayfun, AU - Caglar,Kayser, AU - Oguz,Yusuf, AU - Taslipinar,Abdullah, AU - Vural,Abdulgaffar, AU - Gok,Mahmut, AU - Unal,Hilmi Umut, AU - Yenicesu,Mujdat, AU - Carrero,Juan Jesús, Y1 - 2011/06/23/ PY - 2011/6/25/entrez PY - 2011/6/28/pubmed PY - 2011/11/9/medline SP - 1617 EP - 25 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 6 IS - 7 N2 - BACKGROUND AND OBJECTIVES: Deterioration of kidney function impairs testosterone production, with hypogonadism being common in men with chronic kidney disease (CKD). In nonrenal populations, testosterone is suggested to participate in the atherosclerotic process. In male dialysis patients, we showed that low testosterone increases the risk of mortality. We here studied plausible links among testosterone levels, vascular derangements, and cardiovascular events in nondialysis CKD men. DESIGN, SETTING, PARTICIPANTS, & METHODS: This was a cross-sectional analysis in which flow-mediated dilation (FMD) was assessed in 239 CKD male patients (stages 1 to 5; mean age 52 ± 12 years), together with routine measurements, serum total and free testosterone, and follow-up for cardiovascular outcomes. RESULTS: Total and free testosterone levels decreased in parallel with the reduction of kidney function. Multiple regression analyses showed that total and free testosterone significantly and independently contributed to explain the variance of FMD. After a median follow-up of 31 months (range 8 to 35 months), 22 fatal and 50 nonfatal cardiovascular events occurred. In Cox analysis, the risk of cardiovascular events was reduced by 22% for each nanomole-per-liter increment of total testosterone. This reduced risk persisted after adjustment for age, renal function, diabetes mellitus, previous cardiovascular history, C-reactive protein, albumin, and FMD. The same was true for free testosterone concentrations. CONCLUSIONS: The reduction in endogenous testosterone levels observed with progressive CKD was inversely associated with endothelial dysfunction and exacerbated the risk of future cardiovascular events in nondialysis male CKD patients. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/21700826/Endogenous_testosterone_endothelial_dysfunction_and_cardiovascular_events_in_men_with_nondialysis_chronic_kidney_disease_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=21700826 DB - PRIME DP - Unbound Medicine ER -