Endocrine Abstracts

Late onset hypogonadism (LOH) is common in men with coronary artery disease (CAD) but its interaction with endothelial function and arterial structural changes is debatable.

Aim: To investigate whether the LOH in men with CAD predicts endothelial dysfunction.

Methods: Two hundred consecutive men with CAD and successful coronary stent implantation or coronary artery bypass grafting were included to the study group (mean age 59±10 years; acute coronary syndrome 78%, diabetes 29%, currently smokers 44%, hypertension 65%, BMI 29±4.3 kg/m², left ventricular EF% 52±10). All the patients received pharmacotherapy according to the actual ESC recommendations. Non-invasive methods for endothelial function evaluation – flow mediated dilatation of brachial artery (FMD%) and parameter of arterial structural changes – intima-media thickness of common carotid artery (IMT CCA) and common femoral artery (IMT CFA) were measured.

Result: The mean testosterone level in the whole group was 3.8±1.5 ng/ml. LOH was diagnosed in 83 (42%) men. Patients with LOH had a higher hsCRP capacity than eugonadal: median 5 mg/l (25–75Q: 2.9 to 12.2 to 27) vs 3.2 mg/l (25-75Q: 1.3 to 8.8), P=0.007; NT-proBNP level median 48 pg/ml (25–75Q: 241 to 686) vs 263 pg/ml (25–75Q: 102 to 616); P=0.008. After adjusting for BMI, age, current smokers, NT-proBNP, left ventricular EF, hsCRP, in males with LOH FMD% was still significantly lower than in normal eugonadal males: 6.3 (95%CI: 5.2 to 7.4) vs 8.5 (95%CI: 7.6 to 9.4), mean difference 2.2 (95%CI: 0.8 to 3.6 P=0.002). LOH didn’t influence IMT CCA: mean difference 0.05 (P=0.17) and IMT CFA mean difference 0.05 (P=0.77).

Conclusion: LOH in males with CAD coexists with impaired endothelial but not with arterial structural changes. This relationship requires further investigation.