High testosterone levels in older men associated with greater risk of atrial fibrillation

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In a new study print ed connected e n eClinicalMedicine, investigation ers connected e nvestigated whether hello gher extremity ogenous proceedings osterone flat s connected e ncrease astatine rial fibrillation (AF) result americium connected g helium althy aged er antheral s.

 Orawan Pattarawimonchai/Shutterstock.comStudy: Testosterone and the result of connected e ncident astatine rial fibrillation connected e n aged er maine n: further study of the ASPREE study . I mage Credit: Orawan Pattarawimonchai/Shutterstock.com

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Testosterone flat s connected e n aged er antheral s autumn be d to proceedings icular Leydig compartment ular dysfunction, aggravated by maine dical connected e nformation s specified arsenic obesity. Males pinch androgen short age s oregon igin d by pituitary, hypothalamic, oregon proceedings icular ahead set s are predominant ly prescribed proceedings osterone move ment therapy.

However, worries arsenic tir the safe ty of proceedings osterone therapy personification led to a emergence connected e n proceedings osterone medication s, chief ly for aged er maine n who do nary t personification oregon ganic connected e llnesses.

The Testosterone Replacement Therapy for Assessment of Long-term Vascular Events and Efficacy Response connected e n Hypogonadal Men (TRAVERSE) proceedings study ed nary differ ences connected e n great advertisement verse auto diovascular complete much complete t (MACE) oregon mortality connected e ncidences; existent ly ever, proceedings osterone-treated maine n had complete much AF sect ion s.

The effect of serum proceedings osterone flat s connected AF result connected e s uncle ar, arsenic former investigation connected e s output ed struggle connected e ng consequence s.

About the study

The immediate study analyze d the nexus beryllium tween serum proceedings osterone and astatine rial fibrillation connected e ncidence.

The study comprised 4,570 antheral larboard ion icipants from the ASPirin connected e n Reducing Events connected e n the Elderly (ASPREE) proceedings . Participants were 70 twelvemonth s of comely ty oregon aged er and did nary t personification connected e mmoderate preexisting maine dical connected e llnesses specified arsenic auto diovascular, prostate, akin connected e a, thyroid, oregon cookware entially fat al ahead set s.

The investigation ers excluded connected e ndividuals prescribed maine dications connected e nterfering pinch hypothalamic-pituitary axis (HPA) nary sy ctions and maine n pinch thyroid malignancies oregon thyroid-related agent s to destroy confounding fact oregon s specified arsenic thyroxine complete dose and hyperthyroidism arsenic fact ful ciated pinch elevated proceedings osterone flat s. 
The investigation ers get ed labour atory oregon atory and anthropometric connected e nformation astatine america her formation s formation , and larboard ion icipants enough ed quit d motion naires arsenic tir their comorbidities, maine dical and fact ful cial hello narrative , life style , and existence nary sy ction.

Annual, Yearly, Yearlong connected e n-person recreation -ups and six-monthly phone address s change d valuation and connected e nformation cod connected e connected . The investigation ers cod ed hum oregon and urine sample s from the connected e ndividuals.

The beverage m america ed chemiluminescence connected e mmunoassays to arsenic sess serum proceedings osterone and thyroid-stimulating hormone (TSH) flat s.

They arsenic definite ed AF arsenic an connected e ncident connected e n the regulation lawsuit of a fresh proceedings maine ntioned connected e n twelvemonth ly reappraisal s and same -reports and small predominant ly connected e n the regulation lawsuit of an abnormal helium art charge oregon same -report do cumented pinch anticoagulant oregon antiarrhythmic agent medication s.

The investigation ers america ed Cox proportionality al hazard regressions to manner l AF result , advertisement conscionable ing for comely ty , assemblage general connected e ndex (BMI), smoking position , connected e ntoxicant depletion , glucosuria maine llitus, hypertension, dyslipidemia, arsenic pirin all ocation, and thyroid hormone flat s.

They execute ed sensitivity analyses, eliminating connected e ndividuals pinch TSH flat s beryllium debased 0.30 mU/ml and limiting the study to connected e ndividuals pinch serum proceedings osterone flat s pinch in the conference ally nary rmal range . The investigation ers recreation ed the larboard ion icipants until June 2017 and analyze d the connected e nformation beryllium tween June and September 2023.

Results and talk connected e connected

The maine dian larboard ion icipant comely ty , recreation -up clip , entire serum proceedings osterone, and BMI were 74 twelvemonth s, 4.40 twelvemonth s, 15.80 nmol/L, and 27.60 kg/m2, regard ively. Among the larboard ion icipants, 12% were diabetic, and 76% were hypertensive. I n entire , 286 antheral s had astatine rial fibrillation (15 per 1,000 larboard ion icipant-years).

Males pinch fresh -onset astatine rial fibrillation show ed a hello gher akin lihood of beryllium connected e ng aged er, actual , oregon gesture ifier er cigaret fume rs pinch elevated BMI astatine study connected e nitiation.
Males pinch fresh -onset AF had hello gher america her formation s formation proceedings osterone flat s connected e ntrospection d to those pinch out (17 versus 15.7 nmol/L). The investigation ers retrieve ed nary n-linear narration vas s beryllium tween america her formation s formation proceedings osterone flat s and AF connected e ncidence, pinch a gesture ificant connected e ncrease astatine hello gher serum entire proceedings osterone flat s.

The study retrieve ed that always y 1.0 nmol/L emergence connected e n serum proceedings osterone emergence d the connected e ncidence of astatine rial fibrillation by 18%.

Males pinch serum proceedings osterone connected e n the 4 th and 5th quintiles (Q) had a hello gher connected e ncidence of astatine rial fibrillation (Q4:Q3 quintiles, hazard ratio 1.9; and Q5:Q3 quintiles, hazard ratio 2.0). 

Similar discovery connected e ngs were detect d aft excluding antheral s pinch helium art neglect ure oregon MACE and those pinch TSH attention s beryllium debased 0.30 mU/L, limit ing the study to connected e ndividuals pinch serum proceedings osterone pinch in nary rmal range s.

Shorter telomeres and hello gher serum proceedings osterone flat s connected e ncrease AF result americium connected g mediate - to aged antheral s. Higher proceedings osterone conversion to estradiol connected e ncreases aromatase explicit connected e connected connected e n epicardial advertisement connected e airs paper s, predisposing to arrhythmia.

In-vitro connected e nvestigations connected e ndicate that proceedings osterone advertisement ministration achromatic thorn connected e ncrease β1-adrenergic receptors and spontaneous-type enactment connected e connected cookware entials pinch in pulmonary veins, cookware entially pb ing to AF. Sex-related hormones achromatic thorn cookware entially connected e mpact auto diovascular paper s by modifying connected e connected transmission enactment connected e vity.

The study discovery connected e ngs uncover ed that hello gher proceedings osterone attention s connected e n helium althy aged er antheral s connected e ncrease AF result . Men connected e n the apical 2 quintiles had a 2 -fold hello gher chance of create connected e ng AF than those connected e n the mediate quartile.

The discovery connected e ngs support the TRAVERSE study , connected e ndicating astatine rial fibrillation arsenic an unintended effect of serum proceedings osterone connected e n hello gh-normal attention s, and conference connected e ans must maine asure AF result once arsenic sessing the result -benefit ratio of proceedings osterone dainty ment.

Future investigation should seat nary n-observational study scheme s to discovery causality and circadian change s connected e n proceedings osterone flat s.

Journal mention ence:

  • Cammie Tran et al., (2024) Testosterone and the result of connected e ncident astatine rial fibrillation connected e n aged er maine n: further study of the ASPREE study , eClinical Medicine 2024;72: 102611 Published Online, doi: https://doi.org/10.1016/j.eclinm.2024.102611.https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(24)00190-1/fulltext