TRT Increases Marker for Heart Disease in HIV+ Men

Jinzang

Member
If you've watched the documentary "The Widowmaker," you know the calcium artery score is a marker for risk of heart attack. A recent study, reported at an AIDS conference but not yet published, found more coronary artery calcium progression among HIV+ men on TRT than those who were not on TRT. A news article on the talk said:

Haberlen and colleagues analyzed 300 men with HIV aged 40 to 70 years from the CVD ancillary study of the Multicenter AIDS Cohort Study, of whom 15% were ongoing users of testosterone therapy (use at baseline and follow-up scans), 7% were new users (use at follow-up scan but not baseline scan) and 8% were former users who had stopped by the time of the follow-up scan.
At a mean follow-up of 4.5 years, compared with former users, ongoing users (adjusted RR = 1.99; P < .05) and new users (aRR = 2.37) had elevated risk for CAC progression, Haberlen said.
For noncalcified plaque progression, risk in new users was higher than risk in former users (aRR = 2.16; P < .05), but the same was not true for risk in ongoing users (aRR = 1.52; P > .05), she said.
“Surprisingly, the never-use group also had an elevated risk for progression compared with the former-use group, though not statistically significant,” Haberlen said.
In addition, she said, there was a relationship between baseline low serum total testosterone (< 300 ng/dL) and CAC progression (aRR = 1.97; P < .001), but not between low testosterone and noncalcified plaque progression (aRR = 0.97; P = .93).
 

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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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