Testosterone as the marker of severity of CAD in middle aged Males

OBJECTIVES : 1. To correlate serum testosterone levels in middle aged males with angiographic severity and extent of coronary artery disease. 2. To correlate serum testosterone witha) Flow mediated dilation of brachial artery (BAFMD) b) Clinical profile and risk factors of CAD. METHODS : This prospective cross sectional study included 92 consecutive middle aged male patients admitted for coronary angiogram, in our Department. History and physical examination pertaining to cardiovascular risk factors and cardiovascular system was performed. Patients underwent blood tests, ECG, chest x-ray and echocardiography. Serum total testosterone, sex hormone binding globulin, free and bioavailable testosterone levels were determined. Coronary angiography was done. Severity of CAD was scored according to GENSINI angiographic score. Additionally BAFMD was determined. The analysis was done on the total population as a single group and also after the division of the population into two groups: Normal CAG (controls) and CAD (cases). Then the patients with CAD were further divided into 3 subgroups according to the Gensini scores (Low score : 54) and analysed. RESULTS : This study demonstrated a statistically significant negative correlation between severity of CAD and serum total, free and bioavailable testosterone levels. This study also showed that levels of total, free and bioavailable testosterone correlated positively with BAFMD % in a strong and statistically significant manner. The correlation between testosterone levels and traditional coronary risk factors was also negative but statistically insignificant except for fasting and post prandial sugars. In the CAD group, levels of total, free and bioavailable testosterone varied significantly in the 3 subgroups. Multiple linear regression analysis showed that even after adjusting for traditional risk factors, low serum testosterone was independently associated with severity of CAD. Also after adjusting for all coronary risk factors, low serum testosterone was associated with BAFMD % i.e. endothelial function independently. CONCLUSION : This study showed that there is a statistically significant negative correlation between low serum total, free and bioavailable testosterone and severity of coronary artery disease. There is also a positive correlation between the testosterone levels and BAFMD %- a marker of endothelial function. The correlation between various coronary risk factors and serum testosterone was also found out to be negative. This study showed that serum testosterone is independent risk factor for CAD. It has also shown that testosterone is positively associated with endothelial function independently

Patterns of lipid profile abnormalities in hypertensive patients and normotensive subjects: a cross-sectional observational study

Background: It is a well-known fact that hypertension and altered lipid profile or dyslipidaemia are leading risk factors for cardiovascular diseases. The coexistence of these two conditions has remained an interesting matter, among cardiologists and researchers alike. In this study, we analysed the serum lipid patterns of hypertensive patients and normotensive control subjects.Methods: This cross-sectional observational study was conducted in a tertiary healthcare and teaching center of Northwestern India during the period of 2010 and 2011. The study comprised of 100 hypertensive patients and 100 normotensive control subjects. Data were collected regarding demographic details, past medical/drug history and lipid profile including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL) and high-density lipoprotein (HDL).Results: A total of 200 subjects with the age above 20 years were enrolled in the study. The mean BMI in hypertensive patients (24.14±2.15 kg/m2) was significantly higher than normotensive subjects (22.60±2.62 kg/m2) (p<0.05). When we compared the mean of TC and TG among the hypertensive patients and normotensive subjects, highly significant differences were obtained (p<0.001). The significant decline in mean HDL level was observed in hypertensive patients than normotensive subjects (40.41±4.57 versus 44.64±5.97, p<0.005).Conclusions: The dyslipidaemia has been more evident among hypertensive patients. Hence, the measurement of blood pressure and lipid profile are of great importance to prevent cardiovascular diseases, stroke and other comorbidities

Male sex hormone as a correlate of endothelial function in middle-aged Indian males: a cross-sectional prospective observational study

Background: Data on relationship between serum testosterone and endothelial dysfunction measured by brachial artery flow-mediated dilatation (BAFMD) in Indian subset are scarce. The present study was envisaged to assess the correlation between serum testosterone and endothelial dysfunction measured by BAFMD.Methods: From October 2013 till September 2014, 92 Indian male patients aged 40-60 years who underwent investigation of flow-mediated dilatation of the brachial artery using ultra sonography were included. The association between serum testosterone and BAFMD percent-measured endothelial dysfunction was examined.Results: Multivariate regression analysis in 92 Indian male patients (mean age 53.12±6.3 years) revealed that low levels of total serum, serum free and serum bioavailable testosterone were significantly associated with BAFMD% and were independent of age, hypertension, diabetes, body mass index (BMI), current smoking and hyperlipidaemia (p<0.001). The total serum, serum free and serum bioavailable testosterone were positively correlated with BAFMD% with Pearson correlation coefficients of r=0.572, r=0.525 and r=0.547, respectively (p<0.001).Conclusions: Low levels of total serum, serum free and serum bioavailable testosterone were significantly associated with BAFMD%-measured endothelial dysfunction, irrespective of cardiovascular risk factors

Testosterone as a marker of coronary artery disease severity in middle aged males

AbstractHistorically, higher levels of serum testosterone were presumed deleterious to the cardiovascular system. In the last two decades, studies have suggested that low testosterone levels are associated with increased prevalence of risk factors for cardiovascular disease (CVD), including dyslipidemia and diabetes. This is a cross sectional study. The aim of our study was to determine the relationship between serum testosterone levels and angiographic severity of coronary artery disease (CAD). Serum testosterone levels were also correlated with flow mediated dilation of brachial artery (BAFMD) – an indicator of endothelial function. Consecutive male patients, aged 40–60 years, admitted for coronary angiography (CAG) with symptoms suggestive of CAD, were included in the study. Out of the 92 patients included in the study, 32 patients had normal coronaries and 60 had CAD on coronary angiography. Severity of CAD was determined by Gensini coronary score. The group with CAD had significantly lower levels of total serum testosterone (363±147.1 vs 532.09±150.5ng/dl, p<0.001), free testosterone (7.1215±3.012 vs 10.4419±2.75ng/dl, p<0.001) and bioavailable testosterone (166.17±64.810 vs 247.94±62.504ng/dl, p<0.001) when compared to controls. Adjusting for the traditional risk factors for CAD, a multiple linear regression analysis showed that low testosterone was an independent predictor of severity of CAD (β=−0.007, p<0.001). This study also showed that levels of total, free and bioavailable testosterone correlated positively with BAFMD %