Older men receiving testosterone treatment with higher waist-to-hip ratio (WHR) experience greater increases in noncalcified coronary plaque volume, according to study results published in The Journal of Clinical Endocrinology & Metabolism.

Several studies have explored the effect of testosterone treatment on cardiovascular risk, reporting conflicting results. The Testosterone Trials included men aged ≥65 years with evidence of hypogonadism who were randomly assigned to placebo gel or testosterone 1% gel. The Cardiovascular Trial of the Testosterone Trials reported that in older men with hypogonadism, testosterone treatment was associated with greater progression of noncalcified plaque.

The goal of this study was to assess the impact of baseline anthropometric measures and cardiovascular biomarkers on the progression of coronary artery plaque volume in patients from this cardiovascular evaluation study of the Testosterone Trials.

The study included 170 patients, of whom 138 (mean age, 71.2 years) completed the study. Of these, 73 received testosterone treatment (average body mass index, 30.6±3.8 kg/m2; mean WHR, 1.0) and 65 received placebo (average body mass index, 30.5±3.5 kg/m2; mean WHR, 1.0).


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Of various anthropometric measures and cardiovascular biomarkers evaluated for possible correlations with the progression of coronary artery plaque volume, the only significant interaction was between treatment assignment and WHR in the testosterone group (P =.007).

The model used in the study indicated that for every 0.1 change in WHR (baseline WHR value range, 0.9-1.2), 12-month treatment with testosterone was associated with an increase of 26.96 mm3 (95% CI, 7.72-46.20 mm3) in noncalcified plaque volume.

The researchers noted several study limitations, including the use of a surrogate marker and not a clinical outcome to measure heart disease, as well as limiting the study population to elderly men with low testosterone levels. As such, the results may not apply to other populations.

“[A]mong older men receiving testosterone treatment, those with higher vs. lower WHR may experience greater increases in noncalcified coronary plaque volume,” concluded the researchers.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Reference

Shaikh K, Ellenberg SS, Nakanishi R, et al. Biomarkers and non-calcified coronary artery plaque progression in older men treated with testosterone [published online November 30, 2019]. J Clin Endocrinol Metab. doi:10.1210/clinem/dgz242