Low testosterone levels are associated with coronary artery disease in male patients with angina
Low testosterone levels are associated with coronary artery disease in male patients with angina
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DOI：
10.1038/sj.ijir.3901504
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发表时间：
2007-03-01
影响因子：
2.6
通讯作者：
Fini, M.
中科院分区：
文献类型：
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作者：
Rosano, G. M. C.;Sheiban, I.;Fini, M.
从历史上看，高雄激素水平与冠状动脉疾病（CAD）的风险增加有关。然而，最近的数据表明，低雄激素水平与不良心血管危险因素有关，包括致动脉粥样硬化的脂质谱、肥胖和胰岛素抵抗。本研究的目的是评价接受冠状动脉造影术的患者和匹配的对照组中血浆性激素水平与CAD的存在和程度之间的关系。我们评价了129例连续男性患者（平均年龄58 ± 4岁，范围43-72岁），这些患者因提示CAD的症状而接受诊断性冠状动脉造影，但没有急性冠状动脉综合征或既往诊断为性腺功能减退症。患者与健康志愿者匹配。在129例患者中，119例已证实CAD;特别是，其中32例分别有1支、63例有2支和24例有3支血管疾病。患者的睾酮水平显著低于对照组（9.8+/-6.5 nmol/l和13.5+/-5.4 nmol/l，P < 0.01），促性腺激素水平显著高于对照组（促卵泡激素和促黄体激素分别为12.0+/-1.5 vs 6.6+/-1.9 IU/l和7.9+/-2.1 vs 4.4+/-1.4，P < 0.01）。此外，患者的生物可利用睾酮和血浆雌二醇水平均低于对照组（0.84+/-0.45 vs 1.19+/-0.74 nmol/l，P < 0.01和10.7+/-1.4 vs 13.3+/-3.5 pg/ml，P < 0.05）。比较了单支、双支或三支血管病变患者的激素水平，显示出与冠状动脉疾病严重程度增加相关的显著差异。血浆睾酮水平与冠心病严重程度呈负相关（r=-0.52，P
Historically, high androgen levels have been linked with an increased risk for coronary artery disease (CAD). However, more recent data suggest that low androgen levels are associated with adverse cardiovascular risk factors, including an atherogenic lipid profile, obesity and insulin resistance. The aim of the present study was to evaluate the relationship between plasma sex hormone levels and presence and degree of CAD in patients undergoing coronary angiography and in matched controls. We evaluated 129 consecutive male patients (mean age 58+/-4 years, range 43-72 years) referred for diagnostic coronary angiography because of symptoms suggestive of CAD, but without acute coronary syndromes or prior diagnosis of hypogonadism. Patients were matched with healthy volunteers. Out of 129 patients, 119 had proven CAD; in particular, 32 of them had one, 63 had two and 24 had three vessel disease, respectively. Patients had significantly lower levels of testosterone than controls (9.8+/-6.5 and 13.5+/-5.4 nmol/l, P < 0.01) and higher levels of gonadotrophin (12.0+/-1.5 vs 6.6+/-1.9 IU/l and 7.9+/-2.1 vs 4.4+/-1.4, P < 0.01 for follicle-stimulating hormone and luteinizing hormone, respectively). Also, both bioavailable testosterone and plasma oestradiol levels were lower in patients as compared to controls (0.84+/-0.45 vs 1.19+/-0.74 nmol/l, P < 0.01 and 10.7+/-1.4 vs 13.3+/-3.5 pg/ml, P < 0.05). Hormone levels were compared in cases with one, two or three vessel disease showing significant differences associated with increasing severity of coronary disease. An inverse relationship between the degree of CAD and plasma testosterone levels was found (r= -0.52, P