Endothelial dysfunction, insulin resistance and inflammation in congenital hypogonadism, and the effect of testosterone replacement

Endocrine Journal

Cem Barcin³  Serkan Tapan⁶  Yalcin Basaran⁵  Omer Azal⁵  Alper Sonmez⁵  Mahmut Yazici⁵  Abdullah Taslipinar⁵  Mustafa Dinc⁵  Aydogan Aydogdu⁵  Coskun Meric⁵  Cem Haymana⁵  Erol Bolu⁴  Mahmut Ilker Yilmaz¹  Kamil Baskoy² 

[1] Department of Nephrology, Gulhane School of Medicine, 06018 Etlik Ankara, TURKEY;Department of Endocrinology and Metabolism, Haydarpasa Training Hospital, 34668 Istanbul, TURKEY;Department of Cardiology, Gulhane School of Medicine, 06018 Etlik Ankara, TURKEY;Department of Endocrinology and Metabolism, Memorial Atasehir Hospital, 34750 Atasehir Istanbul, TURKEY;Department of Endocrinology and Metabolism, Gulhane School of Medicine, 06018 Etlik Ankara, TURKEY;Department of Biochemistry, Gulhane School of Medicine, 06018 Etlik Ankara, TURKEY

关键词: Endothelial dysfunction;    Insulin resistance;    Inflammation;    Hypogonadism;   

DOI  :  10.1507/endocrj.EJ15-0125

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(48)Patients with hypogonadism have poor cardiovascular and metabolic outcomes, and the effect oftestosterone replacement therapy (TRT) is not clear.We investigated the presence of inflammation, insulin resistance and endothelial dysfunction in an unconfounded population of congenital hypogonadotrophic hypogonadism (CHH) and the effect of TRT on these subjects.A total of 60 patients with CHH (mean age 21.82±2.22 years) and 70 healthy control subjects (mean age 21.32±1.13 years) were enrolled.The demographic parameters, Asymmetric dimethylarginine (ADMA), TNF-like weak inducer of apoptosis (TWEAK), high sensitive C reactive protein (hs-CRP) and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured before and after TRT.The patients had higher Waist Circumferences (WC) (p=0.009), Diastolic Blood Pressures (p=0.02), Triglycerides (p=0.03), ADMA, insulin and HOMA-IR levels (p<0.001 for all) and lower TWEAK levels (p<0.001), compared to the healthy controls.After 5.56 ± 2.04 months ofTRT, the patients had significantly elevated systolic blood pressures (p=0.01), body mass indexes and WC (p<0.001 and p=0.001 respectively) and decreased total and HDL cholesterol levels (p=0.032 and p<0.001 respectively).ADMA levels significantly increased (p=0.003), while the alterations in TWEAK, hsCRP and HOMA-IR were not significant.The results of the present study show that endothelial dysfunction, inflammation and insulin resistance are prevalent even in the very young subjects with CHH, who have no metabolic or cardiac problems at present.This increased cardiometabolic risk however, do not improve but even get worse after six months of TRT.Long term follow-up studies are warranted to investigate the unfavorable cardiometabolic effects of TRT.

【 授权许可】

Unknown