Horm Metab Res 2014; 46(02): 116-119
DOI: 10.1055/s-0033-1355380
Original Basic
© Georg Thieme Verlag KG Stuttgart · New York

Testosterone Therapy Improves the Heart Rate Turbulence Without Effect on NT-proBNP Level in Men with Metabolic Syndrome

A. R. Poliwczak*
1   Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
,
M. Tylińska*
1   Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
,
M. Broncel
1   Department of Internal Diseases and Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
› Author Affiliations
Further Information

Publication History

received 05 June 2013

accepted 26 August 2013

Publication Date:
23 September 2013 (online)

Abstract

It is now known that BNP and NT-proBNP levels are decreasing with increased BMI, regardless of other metabolic syndrome (MS) constituents. Additionally, testosterone deficiency may intensify frequency of ventricular rhythm disorders in obese individuals by inhibition of the parasympathetic system. Determination of heart rhythm turbulence (HRT) is a useful, noninvasive method used for evaluation of equilibrium of the vegetative system. The aim of the study was to evaluate effect of testosterone therapy on HRT and NT-proBNP levels in MS patients. Eighty males were qualified for the study. They were divided into 3 groups: I (n=30), males with testosterone deficiency syndrome and metabolic syndrome (MS+TDS+); II (n=25), males with MS+TDS–; III (n=25), healthy males. The patients with MS+TDS+ received Omnadrem 250 in the form of intramuscular injections for 9 weeks. Laboratory tests and 24-h Holter ECG were taken twice before the therapy and directly after completion of the therapy. Males with MS+TDS+ more often presented irregular HRT parameters and were characterised by lower NT-proBNP levels compared to the healthy individuals. Testosterone replacement therapy caused improvement of HRT and had no significant effect on the NT-proBNP level. Testosterone replacement therapy and body weight reduction may significantly decrease negative consequences of MS and TDS.

* Equal contribution.


 
  • References

  • 1 Salam R, Kshetrimayum AS, Keisam R. Testosterone and metabolic syndrome: The link. Indian J Endocrinol Metab 2012; 16: s12-s19
  • 2 Wu HY, Wang XF, Wang JH, Li JY. Testosterone level and mortality in elderly men with systolic chronic heart failure. Asian J Androl 2011; 13: 759-763
  • 3 Lam CSP, Cheng S, Choong K, Larson MG, Murabito JM, Newton-Cheh C, Bhasin S, McCabe EL, Miller KK, Redfield MM, Vasan RS, Coviello AD, Wang TJ. Influence of Sex and Hormone Status on Circulating Natriuretic Peptides. J Am College Cardiol 2011; 58: 618-626
  • 4 Olsen MH, Hansen TW, Christensen MK, Gustafsson F, Rasmussen S, Wachtell K, Borch-Johnsen K, Obsen H, Jørgensen T, Hildebrandt P. N-terminal pro brain natriuretic peptide is inversely related to metabolic cardiovascular risk factors and the metabolic syndrome. Hypertension 2005; 46: 660-666
  • 5 Bao Y, Shang X, Zhou L, Hu R, Li Y, Ding W. Relationship between N-terminal pro-B-type natriuretic peptide levels and metabolic syndrome. Arch Med Sci 2011; 7: 247-256
  • 6 Sugisawa T, Kishimoto I, Kokubo Y, Makino H, Miyamoto Y, Yoshimasa Y. Association of plasma B-type natriuretic peptide levels with obesity in gender urban Japanese population: the Suita study. Endocr J 2010; 57: 727-733
  • 7 Wang TJ, Larson MG, Levy D, Benjamin EJ, Leip EP, Wilson PWF, Vasan RS. Impact of Obesity on Plasma Natriuretic Peptide Levels. Circulation 2004; 109: 594-600
  • 8 Tentolouris N, Argyrakopoulou G, Katsilambros N. Perturbet Nervus System Function in Metabolic Syndrome. Neuromolecular Medicine 2008; 10: 169-178
  • 9 Yang PC, Kurokawa J, Furukawa T, Clancy CE. Acute Effects of Sex Steroid Hormones on Susceptibility to Cardiac Arrhythmias: A Simulation Study. PLOS Comput Biol. 6 e1000658
  • 10 Schmidt G, Malik M, Barthel P, Schneider R, Ulm K, Rolnitzky L, Camm AJ, Bigger JT, Schömig A. Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction. Lancet 1999; 353: 1390-1396
  • 11 The IDF consensus worldwide definition of the metabolic syndrome http://www.idf.org/webdata/docs/Meta_def_final.pdf (29.10.2012)
  • 12 Wang C, Nieschlag E, Swerdloff RS, Behre H, Hellstrom WJ, Gooren LJ, Kaufman JM, Legros JJ, Lunenfield B, Morales A, Morley JE, Schulman C, Thompson IM, Weidner W, Wu FC. ISA, ISSAM, EAU, EAA and ASA recommendations: investigation, treatment and monitoring of late-onset hypogonadism in males. Aging Male 2009; 12: 5-12
  • 13 Schneider R, Barthel P, Watanabe M. Heart Rate Turbulence on Holter. In: Malik M, Camm JA. eds. Dynamic Electrocardiography. London: Blackwell Futura Publishing; 2004. 20. 190-193
  • 14 Watanabe MA, Schmidt G. Heart rate turbulence: A 5-year revive. Heart Rhythm 2004; 1: 732-738
  • 15 Jones T, Arver S, Behre HM, Buvat J, Meuleman E, Moncada I, Morales AM, Volterrani M, Yellowlees A, Howell JD, Channer KS. TIMES2 Investigators. Testosterone Replacement in Hypogonadal Men With Type 2 Diabetes and/or Metabolic Syndrome (the TIMES2 Study). Diabetes Care 2011; 34: 828-837
  • 16 Bhattacharya RK, Khera M, Blick G, Kushner H, Nguyen D, Miner MM. Effect of 12 months of testosterone replacement therapy on metabolic syndrome components in hypogonadal men: data from the Testim Registry in the US (TRiUS). Endocrine Disorders 2011; 11: 18-28
  • 17 Mehra MR, Uber P, Park MH, Scott RL, Ventura HO, Harris BC, Frohlich ED. Obesity and suppressed B-type natriuretic peptide levels in heart failure. J Am College Cardiol 2004; 43: 1590-1595
  • 18 Fox ER, Musani SK, Bidulescu A, Nagarajarao HS, Samdarshi TE, Gebreab SY, Sung JH, Steffes MW, Wang TJ, Taylor HA, Vasan RS. Relation of Obesity to Circulating B-Type Natriuretic Peptide Concentrations in Blacks: The Jackson Heart Study. Circulation 2011; 124: 1021-1027
  • 19 Koskinen T, Kähönen M, Jula A, Mattsson T, Keltikangas-Järvinen L, Viikari J, Välimäki I, Rönnemaa T, Raitakari QT. Metabolic syndrome and short-term heart rate variability in young adults. The cardiovascular risk in young Finns study. Diabetic Med 2009; 26: 354-361
  • 20 Brunner EJ, Hemingway H, Walker BR, Page M, Clarke P, Juneja M, Shipley MJ, Kumari M, Andrew R, Secki JR, Papadopoulos A, Checkley S, Rumley A, Lowe GD, Stansfeld SA, Marmot MG. Adrenocortical, autonomic and inflammatory causes of the metabolic syndrome: nested case-control study. Circulation 2002; 106: 2659-2665
  • 21 Emdin M, Gastaldelli A, Muscelli E, Macerata A, Natali A, Camastra S, Ferrannini E. Hyperinsulinemia and autonomic nervous system dysfunction in obesity: Effects of weight loss. Circulation 2001; 103: 513-519
  • 22 Iwasa A, Hwa M, Hassankhani A, Liu T, Narayan SM. Abnormal Heart Turbulence Predict the Initiation of Ventricular Arrhythmias. PACE 2005; 28: 1189-1197
  • 23 Hermans EJ, Putman P, Baas JM, Gecks NM, Kenemans JL, Van Honk J. Exogenuous testosterone attenuates the integrated central stress response in healthy young women. Psychoneuroendocrinology 2007; 32: 1052-1061
  • 24 English KM, Steeds RP, Jones TH, Diver MJ, Channer KS. Low-Dose Transdermal Testosterone Therapy Improves Angina Threshold in Men With Chronic Stable Angina: A Randomized, Double-Blind, Placebo-Controlled Study. Circulation 2000; 102: 1906-1911
  • 25 Wehr E, Pilz S, Boehm BO, März W, Grammer T, Obermayer-Pietsch B. Low free testosterone is associated with heart failure mortality in older men referred for coronary angiography. Eur J Heart Failure 2011; 13: 482-488
  • 26 Wranicz JK, Rosiak M, Cygankiewicz I, Kula P, Kula K, Zaręba W. Sex Steroids and Heart Rate Variability In Patients after Myocardial Infarction. Ann Noninvasive Electrocardiol 2004; 9: 156-161