Correlation between Free Testosterone and Severity of Coronary Artery Disease in Young Adult Male Patients

Amit Kumar Pramanik^1, , Shihab Md. Rezoyanur Rahman², Kaniz Fatema³, Mohammad Monzurul Alam Bhuiyan⁴, Sheuly Ferdoushi⁴, Mst. Shaila Yesmin⁴, Md. Saiful Islam⁴, Md. Quddusur Rahman⁴, Shaikh Nafia Sultana⁵ and Debatosh Paul⁴

¹Department of Transfusion Medicine, Rajshahi Medical College Hospital, Rajshahi, Bangladesh

²Gaibandha General Hospital, Gaibandha, Bangladesh

³Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh

⁴Department of Laboratory Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

⁵Department of Urology, United Hospital, Dhaka, Bangladesh

Cite this paper:
Amit Kumar Pramanik, Shihab Md. Rezoyanur Rahman, Kaniz Fatema, Mohammad Monzurul Alam Bhuiyan, Sheuly Ferdoushi, Mst. Shaila Yesmin, Md. Saiful Islam, Md. Quddusur Rahman, Shaikh Nafia Sultana and Debatosh Paul. Correlation between Free Testosterone and Severity of Coronary Artery Disease in Young Adult Male Patients. American Journal of Medical and Biological Research. 2021; 9(1):5-9. doi: 10.12691/ajmbr-9-1-2

Abstract

Historically, High level of serum testosterone was thought to have deleterious effect on cardiovascular system. In the last few years, studies have suggested that low testosterone levels are associated with increase prevalence of risk factors for cardiovascular diseases. This study aimed to determine the relationship between free testosterone level and the angiographic severity of coronary artery disease in young adult male patients. This cross-sectional study was conducted at Department of Laboratory Medicine in collaboration with Department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) and National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh from March, 2020 to February, 2021. Total 110 subjects from inpatient Department of Cardiology were enrolled, 60 were CAD patients and 50 were Normal Coronaries according to coronary angiography report. Serum level of free testosterone was significantly lower in CAD group than Normal coronaries (4.74±2.10 vs 9.36±3.69 pg/ml, p=0.001). There were significant negative correlation between free testosterone with Gensini score (r= -0.739, p=0.001). Low level of free testosterone was negatively correlated with CAD and its severity in young adult male.

Keywords:
Coronary artery diseases Gensini score free testosterone young adult male

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]	Kim MC, Kini AS, Fuster V, Definition of acute coronary syndromes, Hurst’s The Heart, McGraw Hill, New York, 2011, 1287-95.
[2]	Morris, P.D. and Channer, K.S., “Testosterone and cardiovascular disease in men,” Asian journal of andrology, 14(3).428.2012.
[3]	Newby DE, Grubb NR, Bradbury A, Cardiovascular Disease: Acute Coronary Syndrome, Davidson’s Principle and Practice of Medicine, Churchill Livingstone, Elsvier, Edinburgh, 2014, 589-93.
[4]	Chauhan, A., Singh, S.P., Sharma, S., Agarwal, S. and Varma A., “A study of clinical profile of acute coronary syndrome and its correlation with serum free testosterone level in men in tertiary care hospital of Uttarkhand,” International Journal Of Scientific Research, 7(5). 51-53. 2018.
[5]	Harman, S.M., Metter, E.J., Tobin, J.D., Pearson, J. and Blackman, M.R., “Longitudinal effects of aging on serum total and free testosterone levels in healthy men,” The Journal of Clinical Endocrinology & Metabolism, 86(2).724-731. Feb. 2001.
[6]	Feldman, H.A., Longcope, C., Derby, C.A., Johannes, C.B., Araujo, A.B., Coviello, A.D., Bremner, W.J. and McKinlay, J.B., “Age trends in the level of serum testosterone and other hormones in middle-aged men: longitudinal results from the Massachusetts male aging study,” The Journal of Clinical Endocrinology & Metabolism, 87(2). 589-598. Feb.2002.
[7]	Ly, L.P., Sartorius, G., Hull, L., Leung, A., Swerdloff, R.S., Wang, C. and Handelsman, D.J., “Accuracy of calculated free testosterone formulae in men,” Clinical endocrinology, 73(3). 382-388. Sep. 2010.
[8]	Freedman, D.S., O'Brien, T.R., Flanders, W.D., DeStefano, F. and Barboriak, J.J., “Relation of serum testosterone levels to high density lipoprotein cholesterol and other characteristics in men,” Arteriosclerosis and thrombosis: a journal of vascular biology, 11(2).307-315. Mar. 1991.
[9]	Svartberg, J., von Muhlen, D., Schirmer, H., Barrett-Connor, E., Sundfjord, J. and Jorde, R., “Association of endogenous testosterone with blood pressure and left ventricular mass in men. The Tromso Study,” European Journal of Endocrinology, 150(1). 65-72. Jan.2004.
[10]	Cao, J., Chen, T.M., Hao, W.J., Li, J., Liu, L., Zhu, B.P. and Li, X.Y.,”Correlation between sex hormone levels and obesity in the elderly male,” The Aging Male, 15(2). 85-89. Jun.2012.
[11]	Bonithon-Kopp, C., Scarabin, P.Y., Bara, L., Castanier, M., Jacqueson, A. and Roger, M., “Relationship between sex hormones and haemostatic factors in healthy middle-aged men,” Atherosclerosis, 71(1). 71-76. May, 1988.
[12]	Malkin, C.J., Pugh, P.J., Morris, P.D., Asif, S., Jones, T.H. and Channer, K.S., “Low serum testosterone and increased mortality in men with coronary heart disease,” Heart, 96(22). 1821-1825. Nov. 2010.
[13]	Shores, M.M., Smith, N.L., Forsberg, C.W., Anawalt, B.D. and Matsumoto, A.M., “Testosterone treatment and mortality in men with low testosterone levels,” The Journal of Clinical Endocrinology & Metabolism, 97(6). 2050-2058. Jun. 2012.
[14]	Wu, F.C. and von Eckardstein, A., “Androgens and coronary artery disease,” Endocrine reviews, 24(2). 183-217. Apr. 2003.
[15]	Ohlsson, C., Barrett-Connor, E., Bhasin, S., Orwoll, E., Labrie, F., Karlsson, M.K., Ljunggren, Ö., Vandenput, L., Mellström, D. and Tivesten, Å., “High serum testosterone is associated with reduced risk of cardiovascular events in elderly men: the MrOS (Osteoporotic Fractures in Men) study in Sweden,” Journal of the American College of Cardiology, 58(16). 1674-1681. Oct. 2011.
[16]	Kloner, R.A., Carson, C., Dobs, A., Kopecky, S. and Mohler, E.R., “Testosterone and cardiovascular disease,” Journal of the American College of Cardiology, 67(5). 545-557. 2016.
[17]	Phillips, G.B., Pinkernell, B.H. and Jing, T.Y., “The association of hypotestosteronemia with coronary artery disease in men,” Arteriosclerosis and thrombosis: a journal of vascular biology, 14(5). 701-706. May. 1994.
[18]	Zhao, S.P. and Li, X.P., “The association of low plasma testosterone level with coronary artery disease in Chinese men,” International journal of cardiology, 63(2). 161-164. Jan.1998.
[19]	Hak, A.E., Witteman, J.C., de Jong, F.H., Geerlings, M.I., Hofman, A. and Pols, H.A., “Low levels of endogenous androgens increase the risk of atherosclerosis in elderly men: the Rotterdam study,” The Journal of Clinical Endocrinology & Metabolism, 87(8). 3632-3639. Aug. 2002.
[20]	Van den Beld, A.W., Bots, M.L., Janssen, J.A.M.L.L., Pols, H.A.P., Lamberts, S.W.J. and Grobbee, D.E., “Endogenous hormones and carotid atherosclerosis in elderly men,” American journal of epidemiology, 157(1). 25-31. Jan. 2003.
[21]	Akishita, M., Hashimoto, M., Ohike, Y., Ogawa, S., Iijima, K., Eto, M. and Ouchi, Y., “Low testosterone level is an independent determinant of endothelial dysfunction in men,” Hypertension research, 30(11).1029-1034. Nov. 2007.
[22]	Rosano, G.M.C., Sheiban, I., Massaro, R., Pagnotta, P., Marazzi, G., Vitale, C., Mercuro, G., Volterrani, M., Aversa, A. and Fini, M., “Low testosterone levels are associated with coronary artery disease in male patients with angina,” International Journal of Impotence Research, 19(2). 176-182. Mar. 2007.
[23]	Nathan, L., Shi, W., Dinh, H., Mukherjee, T.K., Wang, X., Lusis, A.J. and Chaudhuri, G., “Testosterone inhibits early atherogenesis by conversion to estradiol: critical role of aromatase,” Proceedings of the National Academy of Sciences, 98(6). 3589-3593. Mar. 2001.
[24]	Webb, C.M., McNeill, J.G., Hayward, C.S., De Zeigler, D. and Collins, P., “Effects of testosterone on coronary vasomotor regulation in men with coronary heart disease,” Circulation, 100(16). 1690-1696. Oct. 1999.
[25]	Empen, K., Lorbeer, R., Dörr, M., Haring, R., Nauck, M., Gläser, S., Krebs, A., Reffelmann, T., Ewert, R., Völzke, H. and Wallaschofski, H., “Association of testosterone levels with endothelial function in men: results from a population-based study,” Arteriosclerosis, thrombosis, and vascular biology, 32(2). 481-486. Feb. 2012.
[26]	English, K.M., Mandour, O., Steeds, R.P., Diver, M.J., Jones, T.H. and Channer, K.S., “Men with coronary artery disease have lower levels of androgens than men with normal coronary angiograms,” European heart journal, 21(11). 890-894. Jun. 2000.
[27]	Chou, T.M., Sudhir, K., Hutchison, S.J., Ko, E., Amidon, T.M., Collins, P. and Chatterjee, K., “Testosterone induces dilation of canine coronary conductance and resistance arteries in vivo,” Circulation, 94(10). 2614-2619. Nov. 1996.
[28]	Ehdaie, B., Atoria, C.L., Gupta, A., Feifer, A., Lowrance, W.T., Morris, M.J., Scardino, P.T., Eastham, J.A. and Elkin, E.B., “Androgen deprivation and thromboembolic events in men with prostate cancer,” Cancer, 118(13). 3397-3406. Jul.2012.
[29]	Collins, L. and Basaria, S., “Adverse effects of androgen deprivation therapy in men with prostate cancer: a focus on metabolic and cardiovascular complications,” Asian journal of andrology, 14(2). 222. Mar. 2012.
[30]	Laughlin, G.A., Barrett-Connor, E. and Bergstrom, J., “Low serum testosterone and mortality in older men,” The Journal of Clinical Endocrinology & Metabolism, 93(1). 68-75. Jan. 2008.
[31]	Zhang, N., Zhang, H., Zhang, X.U., Zhang, B., Wang, F., Wang, C., Zhao, M., Yu, C., Gao, L., Zhao, J. and Guan, Q., “The relationship between endogenous testosterone and lipid profile in middle-aged and elderly Chinese men,” Eur J Endocrinol, 170(4). 487-94. Apr. 2014.
[32]	Isidori, A.M., Caprio, M., Strollo, F., Moretti, C., Frajese, G., Isidori, A. and Fabbri, A., “Leptin and androgens in male obesity: evidence for leptin contribution to reduced androgen levels,” The Journal of Clinical Endocrinology & Metabolism, 84(10). 3673-3680. Oct. 1999.
[33]	Tang, J.J., Srivastava, R.A., Krul, E.S., Baumann, D., Pfleger, B.A., Kitchens, R.T. and Schonfeld, G., “In vivo regulation of apolipoprotein AI gene expression by estradiol and testosterone occurs by different mechanisms in inbred strains of mice,” Journal of lipid research, 32(10).1571-1585. Oct. 1991.
[34]	Miller, M., Stone, N.J., Ballantyne, C., Bittner, V., Criqui, M.H., Ginsberg, H.N., Goldberg, A.C., Howard, W.J., Jacobson, M.S., Kris-Etherton, P.M. and Lennie, T.A., “Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association,” Circulation, 123(20). 2292-2333. May. 2011.