A 3-year observation of testosterone deficiency in Chinese patients with chronic heart failure

Abstract

Testosterone deficiency is present in a certain proportion men with chronic heart failure (CHF). Low testosterone levels in American and European patients with CHF lead to the high mortality and readmission rates. Interestingly, this relationship has not been studied in Chinese patients. To this end, 167 Chinese men with CHF underwent clinical and laboratory evaluations associated with determinations of testosterone levels. Total testosterone (TT) levels and sex hormone-binding globulin were measured by chemiluminescence or immunoassays assays and free testosterone (FT) levels were calculated, Based upon results from these assays, patients were divided into either a low testosterone (LT; n = 93) or normal testosterone (NT; n = 74) group. Subsequently, records from each patient were reviewed over a follow-up duration of at least 3 years. Patients in the LT group experienced worse cardiac function and a higher prevalence of etiology (ischemic vs. no ischemic) and comorbidity (both P < 0.05). In addition, readmission rates of patients in the LT group were higher than that of patients in the NT group (3.32 ± 1.66 VS 1.57 ± 0.89). Overall, deficiencies in FT levels were accompanied with increased mortalities (HR = 6.301, 95% CI 3.187–12.459, P < .0001).

Testosterone, cardiomyopathies, and heart failure

“…The prognostic value of testosterone was demonstrated in 167 Chinese men with CHF who were followed up for at least 3 years. 60 Compared with those with normal testosterone levels, patients with low testosterone levels had more severe cardiac dysfunction, a higher prevalence of ischemic etiology, and more comorbidities. Readmission rates were also higher for patients with low testosterone levels than for patients in the normal testosterone group.…”

Men with Latent Autoimmune Diabetes and Type 2 Diabetes May Have Different Change Patterns in Free Testosterone

“…Moreover, T2D patients with low T levels had poor glycemic control and increased insulin resistance, which may contribute to the longer duration of diabetes [7]. Very recently, researchers confirmed that type 2 diabetic men, especially those with low TT concentrations, have increased all-cause mortality [8,9], leading to a high prevalence of worsening cardiac function, ischemia, and readmission rate [8].…”

Efeitos da deficiência anabólica hormonal e alterações neurovasculares no prognóstico de pacientes com insuficiência cardíaca

“…Regardless of HF aetiology, anaemia has been associated with worsening HF 39 just like low ALM. 40 In univariable and multivariable logistic regression analysis for each group separately, only ALM in patients with dilated cardiomyopathy was independently associated with absolute peak VO 2 (median value), implying that the association seen in our results was driven by a higher ALM of these patients (Table 3).…”

“…A deficiência anabólica hormonal em pacientes com ICFEr também apresenta associação com um aumento significativo de peptídeo natriurético cerebral (BNP), importante marcador de pior prognóstico nesta população 34,36 . Ademais, pacientes com ICFEr e deficiência anabólica hormonal, quando comparados com seus pares sem deficiência, apresentam maior tempo de internação e uma maior frequência de readmissão 40,41 . Diversos estudos também têm demonstrado o impacto da deficiência anabólica hormonal sobre a mortalidade de pacientes com ICFEr, independente do eixo anabólico acometido 40,41 .…”

“…Ademais, pacientes com ICFEr e deficiência anabólica hormonal, quando comparados com seus pares sem deficiência, apresentam maior tempo de internação e uma maior frequência de readmissão 40,41 . Diversos estudos também têm demonstrado o impacto da deficiência anabólica hormonal sobre a mortalidade de pacientes com ICFEr, independente do eixo anabólico acometido 40,41 . Jankowska e colaboradores demonstraram que múltiplas deficiências anabólicas hormonais no eixo gonadal (TT e TL), adrenal (DHEA-S) e somatotrófico (IGF-1) estavam relacionados com um pior prognóstico nesta população.…”