No previous study has investigated the effect of metformin, administered alone or together with testosterone, on cardiometabolic risk factors in men with hypogonadism. The study included 30 men with late-onset hypogonadism (LOH) and impaired glucose tolerance (IGT) who had been complying with lifestyle intervention. After 12 weeks of metformin treatment (1.7 g daily), the participants were allocated to one of 2 groups treated for the following 12 weeks with oral testosterone undecanoate (120 mg daily, n=15) or not receiving androgen therapy (n=15). Plasma lipids, glucose homeostasis markers, as well as plasma levels of androgens, uric acid, high-sensitivity C-reactive protein (hsCRP), homocysteine and fibrinogen were determined before and after 12 and 24 weeks of therapy with the final dose of metformin. Patients with LOH and IGT had higher levels of hsCRP, homocysteine and fibrinogen than subjects with only LOH (n=12) or only IGT (n=15). Metformin administered alone improved insulin sensitivity, as well as reduced 2-h postchallenge plasma glucose and triglycerides. Testosterone-metformin combination therapy decreased also total and LDL cholesterol, uric acid, hsCRP, homocysteine and fibrinogen, as well as increased plasma testosterone. The effect of this combination therapy on testosterone, insulin sensitivity, hsCRP, homocysteine and fibrinogen was stronger than that of metformin alone. The obtained results indicate that IGT men with LOH receiving metformin may gain extra benefits if they are concomitantly treated with oral testosterone.

Our results suggest that testosterone may bring more clinical benefits to metformin- than sulfonylurea-treated men with diabetes and LOH.

Introduction: Both angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers were found to reduce plasma levels of proinflammatory cytokines. No previous study has compared their effect on the production of anti-inflammatory cytokines. Material and methods: The study enrolled 52 patients with grade 1 and grade 2 arterial hypertension. The participants were divided into two groups treated with either perindopril (4 mg daily) or telmisartan (40 mg daily). Blood pressure, plasma lipids, glucose homeostasis markers, as well as plasma levels of uric acid, interleukins 4, 10, 13 (IL-4, IL-10, IL-13), and high sensitivity C-reactive protein (hsCRP) were measured at the beginning of the study and six weeks later. Results: Both perindopril and telmisartan reduced systolic (SBP) and diastolic blood pressure (DBP). Although both agents increased serum levels of IL-10, this effect was more pronounced in patients treated with telmisartan. Neither telmisartan nor perindopril affected circulating levels of uric acid, glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, IL-4, IL-13, and hsCRP. The effect of telmisartan on IL-10 slightly correlated with an improvement in insulin sensitivity. Treatment-induced changes in IL-10 did not correlate with hypotensive properties of perindopril and telmisartan. Conclusions: The obtained results indicate that angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers administered for a short period of time produce a relatively week effect on anti-inflammatory cytokines, limited to IL-10, and stronger for telmisartan than for perindopril.

Our results suggest that the effect of atorvastatin on plasma lipids and circulating levels of other cardiovascular risk factors partially depends on thyroid function.

The concentration of NT-proBNP is useful in the diagnosis of syncope and may initially guide the diagnostic process. The NT-proBNP value exceeding 200 pg/ml seems to be the most rational in determining cardiac syncope.