Eid DAOUD, Mohamed A. HELALY, Noha EL-MASHAD

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

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 incelen- mesi amaçlanmıştır. Çalışmaya 50AKSlu (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. AKSlu hastalarda Kortizol, fibrinojen, PAI-1, hsCRP,IL- 6, total kolesterol ve BMI düzeyleri stabil KAH olan hastalardan önemli derecede yüksekti. Her iki grupta da ser- best 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 mekaniz- malar yoluyla KAHna katkıda bulunabilir.

Yaşlı erkeklerde koroner arter hastalığının serum testosteron düzeyi ile ilişkisi var mı?

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 mecha- nisms including increase blood pressure, dyslipidemia, obesity, increased blood coagulation and increased inflammatory activity.

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