Abstract
Objective: Recent studies have shown that low endogenous testosterone in men is associated with coronary artery disease (CAD) and its risk factors such as obesity, hypertension, dyslipidaemia, and diabetes mellitus. This study was planned to investigate the association of low total testosterone levels with premature coronary artery disease. Methods: Thirty one men, 45 years of age or below with documented coronary artery disease (mean age 41 ± 3) constituted the cases. Control group consisted of 31 men below the same age, without having clinically evident coronary artery disease (mean age 37 ± 4). Total testosterone, fasting plasma glucose and serum lipid levels were measured. Results: Mean ages of the two groups were significantly different (p = 0.001). Body mass index (p = 0.843) and hip circumferences (p = 0.097) were not significantly different between the two groups, but waist circumference (p = 0.007) and waist to hip ratio (p = 0.002) were significantly higher among cases. Prevalence of hypertension, diabetes mellitus, and smoking among cases was higher compared to controls. Total testosterone levels of cases were significantly lower than those of controls (11.1 ± 3.2 nmol/L vs. 27.1 ± 4.3 nmol/L, p = 0.001), which remained significant, following adjustment for the clinical covariates (age, BMI, smoking, diabetes mellitus). Plasma glucose (p = 0.016) and HDL-cholesterol (p = 0.001) were significantly different between the groups. Conclusion: Serum total testosterone was significantly lower in patients with premature CAD compared to controls. Low level of total testosterone may be related to the development of premature coronary artery disease. DOI: http://dx.doi.org/10.4038/sjdem.v4i1.7242 Sri Lanka Journal of Diabetes, Endocrinology and Metabolism 2014; 4 : 17-21
Highlights
The age-standardized death rates for coronary heart disease are declining in many developed countries, but are increasing in developing countries such as in Sri Lanka with demographic changes, urbanization, and lifestyle changes [1, 2]
The current study reveals that serum total testosterone concentration was significantly lower in patients with premature coronary artery disease compared to the controls
This finding is consistent with the previous studies suggesting that low testosterone may be a risk factor for the development of Coronary artery disease (CAD) [4, 5, 6]
Summary
The age-standardized death rates for coronary heart disease are declining in many developed countries, but are increasing in developing countries such as in Sri Lanka with demographic changes, urbanization, and lifestyle changes [1, 2]. Coronary artery disease (CAD) is one of the leading causes of mortality in men. Cardiovascular disease accounts for the highest rate of hospital deaths in Sri Lanka [2]. Epidemiological studies have identified an inverse association between testosterone and coronary artery disease in men [4, 5, 6] with reduced testosterone concentrations being linked to premature CAD [7]. There are studies indicating that a low testosterone level is related to the risk factors of cardiovascular disease as well [8, 9, 10]
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