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THE ROLE OF TESTOSTERONE IN THE METABOLIC SYNDROME
Channer, K.S.
Consultant Cardiologist, Royal Hallamshire Hospital, Sheffield S10
2JF
Hon Professor of Cardiovascular Medicine, Sheffield
Hallam University. Dept. of Cardiology, Royal Hallamshire Hospital,
Sheffield Teaching Hospitals NHS Trust, Sheffield, S10 2JF, UK Kevin.Channer@sth.nhs.uk
Ischaemic heart disease remains the biggest cause of death in the
Western world. Although the actual cause of atherosclerosis is unknown
we do know about those factors which are associated with an increased
risk of its premature development.
The cardiac risk factors are not just additive; risk increases exponentially
with each additional factor. Thus, for example in the Interheart
study (Lancet 2004; 364:937-53) of risk factors in 15,000 patients
presenting with first time myocardial infarction in 52 countries
world wide, smoking conferred a relative risk of 2.9, hypertension
1.9, diabetes of 2.4, which added together would give a relative
risk of 7.2 but the actual measured relative risk of all combined
was about 16.
The metabolic syndrome is a combination of obesity, hypertension,
abnormal lipid profile and glucose intolerance or diabetes which
therefore confers a significant cardiovascular risk. Risk factors
increase with age and the cardiovascular effects of atherosclerosis
also become more prevalent with age.
In men ageing and especially trunkal obesity are associated with
low levels of blood testosterone. Several epidemiological studies
have linked low blood testosterone with accelerated atherosclerosis.
In this presentation I will discuss the evidence for this association
and the potential mechanisms implicating causality for the association.
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