Endocrine Abstracts

The relationship between endogenous testosterone concentrations and coronary disease in men is controversial. Recently, it was demonstrated that the glucuronide metabolite of dihydrotestosterone (DHT), androstane-3α, 17β-diol (3-DIOL-G), but not testosterone (T), is strongly associated to several metabolic risk factors (fat mass, insulin, HOMA index, HDL, triglycerides, ApoA1, etc.) in young and elderly men. The object of the present trial was to evaluate the plasma levels of androgens and 3-DIOL-G in middle-aged men with coronary disease in comparison with a control group, independently of some risk factors.

Twenty-five patients (40–65 years old) with a history of cardiovascular disease (infarction, angina, etc.) were matched according to age, lipid status, diabetes and BMI with 33 men (42–63 years old) with no cardiovascular pathology.

Plasma levels of testosterone, 3-DIOL-G, estradiol, glucose and insulin, as well as the 3-DIOL-G/T ratio and HOMA index were determined.

The coronary group showed lower testosterone levels than the control group (3.1±1.0 vs 4.0±1.3 ng/ml, P<0.02) but 3-DIOL-G level and 3-DIOL-G/T ratio were significantly higher (6.7±3.1 vs 4.8±2.8 ng/ml, P<0.02 ±and 2.5±1.4 vs 1.3±0.8, P<0.001, respectively). Besides, the insulin level and HOMA index were higher in the coronary group (10.7±6.1 vs 6.5±3.2 mUI/ml, P<0.002 and 3.2±2.1 vs 1.6±0.8, P<0.004, respectively). Finally, there was an inverse correlation between insulin and testosterone (r=−0.39, P<0.04) while there was a direct correlation between insulin and the HOMA index with 3-DIOL-G/T ratio (r=−0.43, P<0.01, r=0.39, P<0.04, respectively).

The present results indicate that patients with history of coronary disease have higher plasma levels of 3-DIOL-G than controls, independently of their BMI. Unlike testosterone, the metabolite of the potent DHT androgen, is a steroid that correlates with parameters of insulin-resistance. Future studies are required to determine its participation on the development of coronary disease.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.