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Does the serum testosterone level has a relation to coronary artery disease in elderly men?

Year 2013, Volume: 10 Issue: 4, 197 - 202, 01.12.2013

Abstract

The low serum level of testosterone in the elderly subjects may be a contributing factor for coronary artery disease (CAD) through many pathways.The aim of this work is to study serum levels of free testosterone in elderly men with CAD (both those with acute coronary syndrome (ACS) and those with stable CAD). This study was conducted on 100 elderly males with CAD ,one half of them (50 patients) was presented with ACS (with mean age 69.6± 2.44 year), and the other half (50 patients) was presented with stable CAD (with mean age 69.42± 2.14year), in addition to 50 apparently healthy elderly males (with mean age 69.06 ± 1.64year) as a control group. We detected the levels of serum free testosterone, cortisol, fibrinogen, plasminogen activator inhibitor-1(PAI-1), high sensitive C-reactive protein(hsCRP), interleukin-6(IL-6). Cases with CAD had significant lower values of free testosterone and HDL-c, but they had significant higher values of cortisol, fibrinogen, PAI-1, IL-6, hsCRP, in comparison to control group. Cases with ACS had significant higher values of cortisol, hsCRP, IL-6, fibrinogen, PAI-1, total cholesterol and BMI more than those with stable CAD. The free testosterone had significant negative correlation with fibrinogen, PAI-1, , hsCRP and IL-6 in both groups of patients. The lower value of serum free testosterone in elderly male subjects may contribute to CAD in them via multiple mechanisms including increase blood pressure, dyslipidemia, obesity, increased blood coagulation and increased inflammatory activity.

References

  • Glen SK and Boon NA. Coronary artery disease in the el- derly. Rev Clinical Gerontology 1999;9:13-21.
  • Phillips GB, Pinkernell BH, Jing TY: The association of hy- potestosteronemia with coronary artery disease in men. Arterioscler Thromb1994;14: 701-6.
  • Rosano GM, Sheiban I, Massaro R, et al. Low testosterone levels are associated with coronary artery disease in male patients with angina. Int J Imopot Res 2007;19:176-82.
  • Yeap Bu, Hyde Z, Almeida O, et al. Lower testosterone levels predict incident stroke and transient ischemic at- tacks in older men. J Clin Endocrinol Metab 2009;94(7): 2353-9.
  • Braunwald E: Unstable angina. A classification. Circulation 1989; 80: 410- 4.
  • Savonitto S, Ardissino D, and Granger CB. Prognostic val- ue of the admission electrocardiogram in acute coronary syndromes. JAMA 1999; 281(8): 707-13.
  • Paul SP, O´Gara P, Mahjoub ZA, et al. Geriatric patients with acute myocardial infarction: Cardiac risk factor pro- files, presentation, thrombolysis, coronary interventions, and prognosis. Am Heart J 1996; 131(4): 710-5.
  • Dyas J, Read GF, Riad-Fahmy. A simple robust assay for testosterone in male plasma using an I125-radio-ligand and a solid-phase separation technique. Ann Clin Biochem 1979;16:325-31.
  • Riad-Fahmy D, Read GF, Gaskell SJ, Dyas J, Hindawi R. A simple, direct radioimmunoassay for plasma cortisol, featuring a I125 radioligand and a solid-phase separation technique. Clin.Chem1979; 25: 665-8.
  • Kruithof EKO, Nicolosa G, and Bachmann F. Plasminogen activiator inhibitor 1: development of a radioimmunoas- say and observations on its plasma concentration during venous occlusion and after platelet aggregation. Blood 1987; 70: 1645-53.
  • Alessi M, Ailloud M, and Juttor-Vague I: Features of risk thrombosis and atherosclerosis. Feul Biol 1994;179:39- 41.
  • Khaw K, Dowsett M, Folkerd E, et al. Endogenous tes- tosterone and mortality due to all causes, cardiovascu- lar disease, and cancer in men: European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) pro- spective population study. Circulation 2007;116:2694- 701.
  • Liu PY, Death AK, and Handelsman DJ: Androgens and car- diovascular disease. Endocrin Rev 2003;24:313-40.
  • Laughlin GA, Barrett-Connor E, and Bergstrom J. Low serum testosterone and mortality in older men. J Clin Endocr Metab 2008;93:68-75.
  • Haffner SM, Mykkanen L, Valdez RA, and Katz MS: Relationship of sex hormones to lipids and lipoproteins in non-diabetic men. J Clin Endocr Metab 1993;77:1610-5
  • Simon D, Charles MA, Nahoul K, et al. Association be- tween plasma total testosterone and cardiovascular risk factors in healthy adult men: The Telecom Study. J Clin Endocrin Metab 1997;82(2): 682-5.
  • Barud W, Palusinski R, Beltkowski J, and Wojcicka G: Inverse relationship between total testosterone and anti- oxidized low density lipoprotein levels in aging males. Atherosclerosis 2002;164:282-8.
  • Zmuda JM, Cauley JA, Kriska A, Glynn NW, Gutai JP, Kuller LH. Longitudinal relation between endogenous testoster- one and cardiovascular disease risk factors in middle- aged men: a 13 year follow-up of former multiple risk factor intervention trial participants. Am.J.Epidemiol 1997;146: 609-17.
  • Khaw KT and Barrett-Connor E. Blood pressure and en- dogenous testosterone in men: an inverse relationship. J Hypertension 1988;6:329-32.
  • Dobrzycki S, Serwatka W, Nadlewski S, et al. An assess- ment of correlations between endogenous sex hormones levels and the extensiveness of coronary heart disease and the ejection fraction of the left ventricle in males. J Med Invest 2003;50:162-9.
  • Smith G, Ben-Shlomo Y, Beswick A, Yarnell J, Lightman S, and Elwood P: Cortisol, testosterone, and coronary heart disease prospective evidence from the Caperhilly Study. Circulation 2005;112:332-40.
  • Hake AE, Witteman JC, de Jong FH, Geerlings MI, Hofman A, and Pols HA: Low levels of endogenous androgens in- crease the risk of atherosclerosis in elderly men: the Rotterdam study. J Clin Endocrin Metab 2002;87:3632-9.
  • Yialamas MA, Dwyer AA, Hanley E, Lee H, Pitteloud, Hayes FJ. Acute steroid withdrawal reduces insulin sensi- tivity in healthy men with idiopathic hypogonadotrophic hypogonadism. J Clin Endocrin Metab 2007;92:4254- 9.
  • Maggio M, Basaria S, Ble A, Lauretani F, Bandinelli S, Ceda GP, Valenti G, Ling SM, Ferrucci L. Correlation between testosterone and the inflammatory marker soluble in- terleukin-6 receptor in older men. J Clin Endocrin Metab 2006;91:345-7.
  • Malkin CJ, Pugh PJ, Jones RD, Kappor D, Channer KS, Jones TH. The effect of testosterone replacement on endogenous inflammatory cytokines and lipid profiles in hypogonadal men. J Clin Endocrin Metab 2004;89: 3313-8.
  • Dobs AS, Bachorik PS, Arver S, et al. Interrelationships among lipoprotein levels, sex hormones, anthropometric parameters, and age in hypogonadal men treated for 1 year with a permeation-enhanced testosterone transder- mal system. J Clin Endocrin Metab 2001;86:1026-33.

Does the serum testosterone level has a relation to coronary artery disease in elderly men?

Year 2013, Volume: 10 Issue: 4, 197 - 202, 01.12.2013

Abstract

Yaşlı bireylerde düşük testosteron düzeyi, birçok mekanizma ile koroner arter hastalığı (KAH) gelişimine katkıda bulunabilir. Bu çalışmada KAH olan (akut koroner sendromu(AKS) veyastabil KAH olan) yaşlı erkeklerde serbest testosteron düzeylerinin incelenmesi amaçlanmıştır. Çalışmaya 50AKS’lu (ortalama yaş 69.6± 2.44), 50 stabil KAH( ortalama yaş 69.42± 2.14) olan toplam 100 hasta ve kontrol grubu olarak 50 sağlıklı yaşlı (ortalama yaş 69.06± 1.64) alındı. Çalışmaya alınan kişilerin serumserbest testosteron düzeyleri,kortizol, fibrinojen, plazminojenetkinleştirici inhibitör- 1 (PAI-1),yüksek duyarlı C- reaktif protein (hsCRP), interlökin-6 (IL-6) düzeylerine bakıldı.Kontrol grubu ile karşılaştırıldığında, KAH olan olgularda serbest testesteron ve HDL-c düzeyleri anlamlı olarak düşük bulunurken, kortizol, fibrinojen, PAI-1, hsCRP,IL- 6 düzeyleri yüksek bulundu. AKS’lu hastalarda Kortizol, fibrinojen, PAI-1, hsCRP,IL- 6, total kolesterol ve BMI düzeyleri stabil KAH olan hastalardan önemli derecede yüksekti. Her iki grupta da serbest testesteron ile fibrinojen, PAI-1, hsCRP,IL-6 düzeyleri arasında negatif korelasyon vardı. Yaşlı erkek hastalarda serum serbest testosteron düzeyleri, tansiyon artışı, dislipidemi, aşırı şişmanlık, kogülasyon ve enflamatuar aktivite artışı gibi çoklu mekanizmalar yoluyla KAH’na katkıda bulunabilir

References

  • Glen SK and Boon NA. Coronary artery disease in the el- derly. Rev Clinical Gerontology 1999;9:13-21.
  • Phillips GB, Pinkernell BH, Jing TY: The association of hy- potestosteronemia with coronary artery disease in men. Arterioscler Thromb1994;14: 701-6.
  • Rosano GM, Sheiban I, Massaro R, et al. Low testosterone levels are associated with coronary artery disease in male patients with angina. Int J Imopot Res 2007;19:176-82.
  • Yeap Bu, Hyde Z, Almeida O, et al. Lower testosterone levels predict incident stroke and transient ischemic at- tacks in older men. J Clin Endocrinol Metab 2009;94(7): 2353-9.
  • Braunwald E: Unstable angina. A classification. Circulation 1989; 80: 410- 4.
  • Savonitto S, Ardissino D, and Granger CB. Prognostic val- ue of the admission electrocardiogram in acute coronary syndromes. JAMA 1999; 281(8): 707-13.
  • Paul SP, O´Gara P, Mahjoub ZA, et al. Geriatric patients with acute myocardial infarction: Cardiac risk factor pro- files, presentation, thrombolysis, coronary interventions, and prognosis. Am Heart J 1996; 131(4): 710-5.
  • Dyas J, Read GF, Riad-Fahmy. A simple robust assay for testosterone in male plasma using an I125-radio-ligand and a solid-phase separation technique. Ann Clin Biochem 1979;16:325-31.
  • Riad-Fahmy D, Read GF, Gaskell SJ, Dyas J, Hindawi R. A simple, direct radioimmunoassay for plasma cortisol, featuring a I125 radioligand and a solid-phase separation technique. Clin.Chem1979; 25: 665-8.
  • Kruithof EKO, Nicolosa G, and Bachmann F. Plasminogen activiator inhibitor 1: development of a radioimmunoas- say and observations on its plasma concentration during venous occlusion and after platelet aggregation. Blood 1987; 70: 1645-53.
  • Alessi M, Ailloud M, and Juttor-Vague I: Features of risk thrombosis and atherosclerosis. Feul Biol 1994;179:39- 41.
  • Khaw K, Dowsett M, Folkerd E, et al. Endogenous tes- tosterone and mortality due to all causes, cardiovascu- lar disease, and cancer in men: European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) pro- spective population study. Circulation 2007;116:2694- 701.
  • Liu PY, Death AK, and Handelsman DJ: Androgens and car- diovascular disease. Endocrin Rev 2003;24:313-40.
  • Laughlin GA, Barrett-Connor E, and Bergstrom J. Low serum testosterone and mortality in older men. J Clin Endocr Metab 2008;93:68-75.
  • Haffner SM, Mykkanen L, Valdez RA, and Katz MS: Relationship of sex hormones to lipids and lipoproteins in non-diabetic men. J Clin Endocr Metab 1993;77:1610-5
  • Simon D, Charles MA, Nahoul K, et al. Association be- tween plasma total testosterone and cardiovascular risk factors in healthy adult men: The Telecom Study. J Clin Endocrin Metab 1997;82(2): 682-5.
  • Barud W, Palusinski R, Beltkowski J, and Wojcicka G: Inverse relationship between total testosterone and anti- oxidized low density lipoprotein levels in aging males. Atherosclerosis 2002;164:282-8.
  • Zmuda JM, Cauley JA, Kriska A, Glynn NW, Gutai JP, Kuller LH. Longitudinal relation between endogenous testoster- one and cardiovascular disease risk factors in middle- aged men: a 13 year follow-up of former multiple risk factor intervention trial participants. Am.J.Epidemiol 1997;146: 609-17.
  • Khaw KT and Barrett-Connor E. Blood pressure and en- dogenous testosterone in men: an inverse relationship. J Hypertension 1988;6:329-32.
  • Dobrzycki S, Serwatka W, Nadlewski S, et al. An assess- ment of correlations between endogenous sex hormones levels and the extensiveness of coronary heart disease and the ejection fraction of the left ventricle in males. J Med Invest 2003;50:162-9.
  • Smith G, Ben-Shlomo Y, Beswick A, Yarnell J, Lightman S, and Elwood P: Cortisol, testosterone, and coronary heart disease prospective evidence from the Caperhilly Study. Circulation 2005;112:332-40.
  • Hake AE, Witteman JC, de Jong FH, Geerlings MI, Hofman A, and Pols HA: Low levels of endogenous androgens in- crease the risk of atherosclerosis in elderly men: the Rotterdam study. J Clin Endocrin Metab 2002;87:3632-9.
  • Yialamas MA, Dwyer AA, Hanley E, Lee H, Pitteloud, Hayes FJ. Acute steroid withdrawal reduces insulin sensi- tivity in healthy men with idiopathic hypogonadotrophic hypogonadism. J Clin Endocrin Metab 2007;92:4254- 9.
  • Maggio M, Basaria S, Ble A, Lauretani F, Bandinelli S, Ceda GP, Valenti G, Ling SM, Ferrucci L. Correlation between testosterone and the inflammatory marker soluble in- terleukin-6 receptor in older men. J Clin Endocrin Metab 2006;91:345-7.
  • Malkin CJ, Pugh PJ, Jones RD, Kappor D, Channer KS, Jones TH. The effect of testosterone replacement on endogenous inflammatory cytokines and lipid profiles in hypogonadal men. J Clin Endocrin Metab 2004;89: 3313-8.
  • Dobs AS, Bachorik PS, Arver S, et al. Interrelationships among lipoprotein levels, sex hormones, anthropometric parameters, and age in hypogonadal men treated for 1 year with a permeation-enhanced testosterone transder- mal system. J Clin Endocrin Metab 2001;86:1026-33.
There are 26 citations in total.

Details

Primary Language English
Journal Section Original Articles
Authors

Mohamed Helaly This is me

Eid Daoud This is me

Noha El-mashad This is me

Publication Date December 1, 2013
Published in Issue Year 2013 Volume: 10 Issue: 4

Cite

APA Helaly, M., Daoud, E., & El-mashad, N. (2013). Does the serum testosterone level has a relation to coronary artery disease in elderly men?. European Journal of General Medicine, 10(4), 197-202.
AMA Helaly M, Daoud E, El-mashad N. Does the serum testosterone level has a relation to coronary artery disease in elderly men?. European Journal of General Medicine. December 2013;10(4):197-202.
Chicago Helaly, Mohamed, Eid Daoud, and Noha El-mashad. “Does the Serum Testosterone Level Has a Relation to Coronary Artery Disease in Elderly Men?”. European Journal of General Medicine 10, no. 4 (December 2013): 197-202.
EndNote Helaly M, Daoud E, El-mashad N (December 1, 2013) Does the serum testosterone level has a relation to coronary artery disease in elderly men?. European Journal of General Medicine 10 4 197–202.
IEEE M. Helaly, E. Daoud, and N. El-mashad, “Does the serum testosterone level has a relation to coronary artery disease in elderly men?”, European Journal of General Medicine, vol. 10, no. 4, pp. 197–202, 2013.
ISNAD Helaly, Mohamed et al. “Does the Serum Testosterone Level Has a Relation to Coronary Artery Disease in Elderly Men?”. European Journal of General Medicine 10/4 (December 2013), 197-202.
JAMA Helaly M, Daoud E, El-mashad N. Does the serum testosterone level has a relation to coronary artery disease in elderly men?. European Journal of General Medicine. 2013;10:197–202.
MLA Helaly, Mohamed et al. “Does the Serum Testosterone Level Has a Relation to Coronary Artery Disease in Elderly Men?”. European Journal of General Medicine, vol. 10, no. 4, 2013, pp. 197-02.
Vancouver Helaly M, Daoud E, El-mashad N. Does the serum testosterone level has a relation to coronary artery disease in elderly men?. European Journal of General Medicine. 2013;10(4):197-202.