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Endocrine Abstracts (2003) 5 P225

BES2003 Poster Presentations Steroids (39 abstracts)

High prevalence of low testosterone levels in men with coronary heart disease and an association with hypertension and obesity - The South Yorkshire study

PJ Pugh 1,2 , PD Morris 1,2 , J Hall 1 , CJ Malkin 1,2 , S Asif 1,2 , RD Jones 1 , KS Channer 2 & TH Jones 1,3

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1Academic Unit of Endocrinology, Division of Genomic Medicine, University of Sheffield Medical School, Sheffield UK; 2Department of Cardiology, Royal Hallamshire Hospital, Sheffield, UK; 3Centre for Diabetes & Endocrinology, Barnsley District General Hospital, Barnsley, UK.


We(1) and others have established that men with coronary heart disease (CHD) have lower serum testosterone levels than men with normal coronaries. Hypotestosteronaemia is associated with dyslipidaemia, visceral obesity, insulin resistance, hypertension and a prothrombotic state.
The aim of this study was to determine the prevalence of hypogonadism in men with CHD proven by either greater than 70 per cent stenosis of one or more epicardial or greater than 50 per cent stenosis of the main stem of the left coronary artery. Patients with an elevated CRP were excluded.
1146 undergoing elective coronary angiography were recruited of which 831 patients fulfilled the criteria above. Androgen status was assessed by total testosterone (TT)(normal range 7.5 - 35 nanomoles per litre) and bioavailable testosterone (BioT)normal range less than 2.5 nanomoles per litre.
Results - 14.1 per cent had TT less than 7.5 nanomoles per litre, 19.9 per cent BioT less than 2.5 nanomoles per litre. 23.4 per cent had either low TT and/or low BioT. Repeat testing showed close correlation between samples (r=0.89, p=0.0002). TT and BioT levels were significantly lower in subjects with obesity (p less than 0.000001)and a history of hypertension (p=0.036). Hypogonadal symptom scores (ADAM questionnaire) were positive in 93.5 per cent of patients retested with low TT and/or BioT.
This study shows a high prevalence of hypogonadism in men with angiographically proven CHD. This has wide clinical implications suggesting that men with CHD should be screened for hypogonadism and considered for testosterone replacement if indicated and that there are no contraindications.
(1) English et al. Eur Heart Journal 2000; 21: 890-4.

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22nd Joint Meeting of the British Endocrine Societies

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