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Low serum testosterone is associated with atherosclerosis in postmenopausal women undergoing hemodialysis

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

Serum testosterone levels in postmenopausal women undergoing hemodialysis are abnormally low and associated with features of atherosclerosis.

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Acknowledgments

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.

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Authors and Affiliations

  1. Department of Nephrology, Hiroshima University Hospital, 1-2-3 Kasumi Minami-Ku, Hiroshima, 734-8551, Japan

    Nobuaki Shiraki, Ayumu Nakashima, Shigehiro Doi, Toshinori Ueno & Takao Masaki

  2. Department of Regenerative Medicine, Hiroshima University Hospital, Hiroshima, Japan

    Ayumu Nakashima

  3. Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan

    Nobuoki Kohno

  4. Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

    Juan Jesús Carrero & Peter Stenvinkel

  5. Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden

    Juan Jesús Carrero

  6. Department of Nephrology, Kure Kyosai Hospital, Kure, Japan

    Naoko Sugiya

Authors
  1. Nobuaki Shiraki
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  2. Ayumu Nakashima
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  9. Takao Masaki
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Corresponding author

Correspondence to Ayumu Nakashima.

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Shiraki, N., Nakashima, A., Doi, S. et al. Low serum testosterone is associated with atherosclerosis in postmenopausal women undergoing hemodialysis. Clin Exp Nephrol 18, 499–506 (2014). https://doi.org/10.1007/s10157-013-0840-6

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  • DOI: https://doi.org/10.1007/s10157-013-0840-6

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