Low serum testosterone is associated with atherosclerosis in postmenopausal women undergoing hemodialysis
- 288 Downloads
Low serum testosterone levels have been recently linked to endothelial dysfunction, arterial stiffness, and worse outcomes in male hemodialysis patients. We tested the hypothesis that low serum testosterone levels are also associated with atherosclerosis risk factors in postmenopausal women undergoing hemodialysis.
We measured serum testosterone in 115 confirmed postmenopausal ethnically Japanese women undergoing hemodialysis with mean age of 68.1 ± 10.6 years and median dialysis vintage of 73 months. The severity of atherosclerosis was evaluated by carotid intima–media thickness (cIMT) and cardio–ankle vascular index (CAVI). In addition, we also included a control cohort of 32 age-matched postmenopausal women without chronic kidney disease.
Serum testosterone was significantly lower in women undergoing hemodialysis than in age-matched controls. Women undergoing hemodialysis who had undetectable testosterone concentration presented higher cIMT and higher CAVI than women undergoing hemodialysis with testosterone concentration above detection limits (P < 0.05 for all). Multiple logistic regression analyses confirmed the independence of these associations.
Serum testosterone levels in postmenopausal women undergoing hemodialysis are abnormally low and associated with features of atherosclerosis.
KeywordsTestosterone Atherosclerosis Hemodialysis Postmenopausal woman
This study was supported by Grants-in-Aid for kidney failure and hemodialysis research from the Japanese Association of Dialysis Physicians. J.J.C. acknowledges the support of the Swedish Research Council, the Kvinnor och Hälsa and the Loo and Hans Osterman Foundations.
Conflict of interest
J.J.C. and P.S. are investigators of an intervention study to test the effects of testosterone undecanoate in male hypogonadal HD patients with partial support from Bayer Pharmaceuticals. No other author declares a personal or financial conflict of interest.
- 10.Dalia S, Fortune K, Anat J, et al. Effects of gonadal steroids and their antagonists on DNA synthesis in human vascular cells. Hypertension. 1998;32:39–45.Google Scholar
- 12.Cigarran S, Pousa M, Castro MJ, et al. (2013) Endogenous testosterone, muscle strength and fat-free mass in men with chronic kidney disease. J Ren Nutr.Google Scholar
- 40.Nettleship JE, Jones TH, Channer KS, et al. Physiological testosterone replacement therapy attenuates fatty streak formation and improves high-density lipoprotein cholesterol in the Tfm mouse: an effect that is independent of the classic androgen receptor. Circulation. 2007;116:2427–34.PubMedCrossRefGoogle Scholar
- 42.Foresta C, Zuccarello D, De Toni L, et al. Androgens stimulate endothelial progenitor cells through an androgen receptor-mediated pathway. Clin Endocrinol (Oxf). 2008;68:284–9.Google Scholar