New study below.
"We used data from 376 untreated hypogonadal men ..."
"Our findings suggest that the later a male's T dropped below 12.1 nmol/l, the less the lifetime risk of PCa the individual had [Hazard ratio (HR): 0.68"
Note that "12.1 nmol/l" is ~350 ng/dL, the standard cutoff for hypogonadism.
"further declines or dynamic variations of T were associated with increased risk of PCa"
I continue to be dismayed that low testosterone is not recognized as a risk factor for PCa. It is common to cite age as an important risk factor, without explaining why that might be. But the most significant change in males, with age, is the inexorable decline of testosterone levels.
Unfortunately, in countries that have bought into high-carb/low-fat diets, men are more overweight that a generation ago. The British are now the fattest in Europe.
UK food pyramid [2]:
- (bottom) "Bread, Cereal, Rice & Pasta Group 6-11 Servings"
- (top) "Fats, Oils & Sweets use Spairingly"
The result is increased visceral fat, secretion of estradiol & reduction in testosterone production. i.e. an accelerated T decline.
The so-called andropause may be "natural" in the sense that most men experience it, but hypogonadism has consequences that are unacceptable. T replacement has health benefits beyond erections for codgers.
-Patrick
[1] ncbi.nlm.nih.gov/pubmed/289...
J Urol. 2017 Sep 20. pii: S0022-5347(17)77561-1. doi: 10.1016/j.juro.2017.08.117. [Epub ahead of print]
Dynamic Patterns of Testosterone Levels within Individuals and Risk of Prostate Cancer among Hypogonadal Men: A Longitudinal Study.
Xu X1, Zhang X2, Zhong Y3, Saad F4, Perez-Patron MJ2, Haider K5, Haider A5.
Author information
1
Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University. Electronic address: xiaohui.xu@sph.tamhsc.edu.
2
Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University.
3
Department of Statistics, Texas A&M University.
4
Global Medical Affairs Andrology, Bayer AG, Berlin, Germany and Research Department, Gulf Medical University, Ajman, UAE.
5
Private Urology Practice, 27570 Bremerhaven, Germany.
Abstract
PURPOSE:
We proposed to investigate whether dynamic patterns of testosterone (T) levels contribute to risk of prostate cancer (PCa).
MATERIALS AND METHODS:
We used data from 376 untreated hypogonadal men (T ≤ 12.1 nmol/L) recruited from a urology office in Germany. Study entry age was used as a surrogate for age at first detecting T below 12.1 nmol/L; three indicators, the coefficient of variation (CV), the ratio of the largest decline relative to the mean (MMDRM), and the median of the maximum declines (MMD) were derived to measure the dynamic patterns of T within an individual.
RESULTS:
Our findings suggest that the later a male's T dropped below 12.1 nmol/l, the less the lifetime risk of PCa the individual had [Hazard ratio (HR): 0.68, 95% confidence interval (CI): 0.57-0.82]; further declines or dynamic variations of T were associated with increased risk of PCa [CV (High vs. Low): HR=4.88, 95% CI: 1.97-12.08; MMDRM (High vs. Low): HR=8.45, 95% CI: 2.82-25.37; MMD (High vs. Low): HR=2.70, 95%CI: 1.15-6.35].
CONCLUSIONS:
Our study is the first to provide evidence of the association between dynamic patterns of T and PCa development and may have substantial clinical impacts on PCa prevention.
Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
KEYWORDS:
Decline of Testosterone levels; Dynamic model; Prostate Cancer; Testosterone
PMID: 28941925 DOI: 10.1016/j.juro.2017.08.117
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