A New Cardiovascular Risk Marker in Men with Hypogonadism: Alanine Aminotransferase

Abstract

Objective:We aimed to evaluate the effect of testosterone treatment (TT) on cardiovascular risk markers in male patients with isolated hypogonadotropic hypogonadism (IHH). Material and Methods: We included 50 men with IHH who were admitted to the Kahramanmaraş Sütçü İmam University Endocrinology and Metabolism Clinic and 43 healthy men (the control group). The men in the patient group were compared before and after one year of treatment in terms of total testosterone, fasting plasma glucose, alanine aminotransferases (ALT), high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C), platelet volume indices [mean platelet volume and platelet distribution width (PDW)], platelet count, and carotid intima-media thickness (CIMT). Moreover, the patient group was compared with the control group. Results: The mean age of the men in the patient and control groups was 31.6 and 29.6 years, respectively. Patients were divided into pre-(patient group 0 ) and posttreatment (patient group 1 ) groups. The levels of CIMT, TG, and ALT were significantly higher and that of HDL-C was significantly lower in the patient group 0 than the control group (p<0.05). Moreover, the level of body mass index, CIMT, ALT, and LDL-C was significantly lower and that of HDL-C, platelet count, and PDW was significantly higher (p<0.05) in the patient group 1 than the patient group 0 . A statistically significant negative correlation was observed between testosterone levels and LDL-C, TG, ALT, and CIMT levels (r=-0.207, p=0.047; r=-0.265, p=0.010; r=-0.266, p=0.010; and r=-0.410, p<0.001, respectively), and a positive correlation was observed between HDL-C and testosterone levels (r=0.270, p=0.009). Conclusion: Our study showed that atherosclerosis risk increases in untreated hypogonadal men. TT has beneficial effects on ALT, CIMT, and lipid profiles. The decrease in ALT after TT may be an indicator of regression in atherosclerosis and a positive response to treatment.Amaç: İzole hipogonadotropik hipogonadizm (İHH) li erkek hastalarda testosteron tedavisi (TT) nin kardiyovasküler risk belirteçleri üzerine etkisini değerlendirmektir. Gereç ve Yöntemler: Kahramanmaraş Sütçü İmam Üniversitesi Endokrinoloji ve Metabolizma polikliniğine başvuran ortalama yaşları 31,6 olan İHH'li 50 erkek hasta ve yaş ortalaması 29,6 olan 43 sağlıklı erkek kontrol çalışmaya dâhil edildi. Hasta grubu tedavi öncesi ve 1 yıl sonra ortalama total testosteron, açlık plazma glukozu, alanin aminotransferaz (ALT), trigliserid (TG), düşük yoğunluklu lipoprotein (LDL), yüksek dansiteli lipoprotein (HDL), trombosit hacim endeksleri [ortalama trombosit hacmi (OTH), trombosit dağılım genişliği (TDG)], trombosit sayısı ve karotid intima-media kalınlığı (KİMK) açısından karşılaştırıldı. Ayrıca hasta grubu, kontrol grubu ile karşılaştırıldı. Bulgular: Hasta grubu TT öncesi (hasta grubu 0 ) ve TT sonrası (hasta grubu 1 ) olarak bölündü. Hasta grubunda kontrol grubuna göre KİMK, LDL, TG ve ALT düzeyleri anlamlı olarak yüksek, HDL düzeyleri an...