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Vol. 32. Issue 4.
Pages 135-143 (July - August 2020)
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Vol. 32. Issue 4.
Pages 135-143 (July - August 2020)
Original article
DOI: 10.1016/j.artere.2020.07.003
The association of decreased testosterone with atherosclerosis and inflammation in male predialysis patients with chronic kidney disease
Asociación entre el descenso del nivel de testosterona y aterosclerosis e inflamación en varones con insuficiencia renal crónica prediálisis
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Harun Aydemira, Ibrahim Guneyb, Cevdet Duranc,
Corresponding author
drcduran@gmail.com

Corresponding author.
, Vedat Gencerd, Sahabettin Akbayrake, Huseyin Kurkuf, Yavuz Sultan Selim Akgulg, Mustafa Canh, Samil Ecirlig
a The Division of Rheumatology, The Department of Internal Medicine, Meram Medical School of Necmettin Erbakan University, Konya, Turkey
b The Division of Nephrology, The Department of Internal Medicine, Konya Health Application and Research Center, University of Health Sciences, Konya, Turkey
c The Division of Endocrinology and Metabolism, The Department of Internal Medicine, Medical School of Usak University, Usak, Turkey
d The Division of Nephrology, The Department of Internal Medicine, Yozgat State Hospital, Yozgat, Turkey
e The Department of Radiology, Konya Health Application and Research Center, University of Health Sciences, Konya, Turkey
f The Department of Biochemistry, Konya Health Application and Research Center, University of Health Sciences, Konya, Turkey
g The Department of Internal Medicine, Konya Health Application and Research Center, University of Health Sciences, Konya, Turkey
h The Division of Endocrinology and Metabolism, The Department of Internal Medicine, Meram Medical School of Necmettin Erbakan University, Konya, Turkey
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Tables (4)
Table 1. Clinical and laboratory findings of male predialysis patients with CKD according to disease stages.
Table 2. Clinical and laboratory characteristics of male predialysis patients with CKD according to total testosterone levels.
Table 3. Clinical and laboratory characteristics of male predialysis patients with CKD according to free testosterone levels.
Table 4. Correlation analyses of some parameters in predialysis patients with CKD.
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Abstract
Purpose

To investigate the frequency of hypogonadism and its relationship to inflammation and carotid intima-media thickness (CIMT) in male patients with predialysis chronic kidney disease (CKD).

Methods

A total of 105 patients with CKD, 55 (52.4%) as stage 3, 33 (31.4%) as stage 4 and 17 (16.2%) as stage 5, were enrolled into the study. Total testosterone (TT) and free testosterone (FT), interleukin 6 (IL-6), C-reactive protein (CRP) levels, and CIMT were measured.

Results

According to TT and FT, hypogonadism was detected in 18 (17.1%) and 22 (20.9%) patients, respectively. There was no difference in terms of TT and FT, CIMT, CRP and IL-6 between the stages of CKD. According to TT, the patients with hypogonadism had significantly higher CRP and high-density lipoprotein cholesterol (HDL-cholesterol) levels (p=0.004 and p=0.005, respectively). There was no significant difference in other parameters. According to FT, the patients with hypogonadism had significantly higher CRP (p=0.017), and TT were negatively correlated with body mass index (BMI), waist circumference (WC), hip circumference, and CRP levels. FT was negatively correlated with age, waist circumference, systolic blood pressure, diastolic blood pressure (DBP) and CRP.

Conclusions

The frequency of hypogonadism was found around 17–21% among the patients with CKD. Despite similar IL-6 and CIMT levels, CRP was found to be higher in the patients with hypogonadism. We consider that further studies with larger populations are needed to elucidate the entity.

Keywords:
Atherosclerosis
Hypogonadism
Inflammation
Chronic kidney disease
Predialysis
Resumen
Objetivo

Investigar la frecuencia de hipogonadismo y su relación con la inflamación y grosor de la íntima-media carotídea (CIMT) en varones con insuficiencia renal crónica (IRC) prediálisis.

Métodos

Se incluyó en el estudio a un total de 105 pacientes con IRC, 55 (52,4%) en estadio 3, 33 (31,4%) en estadio 4, y 17 (16,2%) en estadio 5. Se midieron testosterona total (TT) y testosterona libre (TL), interleucina 6 (IL-6), niveles de proteína C reactiva (PCR), y CIMT.

Resultados

Con respecto a TT y TL, se detectó hipogonadismo en 18 (17,1%) y 22 (20,9%) pacientes, respectivamente. No se encontraron diferencias en términos de TT y TL, CIMT, PCR e IL-6 entre los diferentes estadios de IRC. Con respecto a TT, los pacientes con hipogonadismo tenían valores significativamente más altos de PCR y colesterol de lipoproteínas de alta densidad (HDL-colesterol) (p=0,004 y p=0,005, respectivamente). No se encontraron diferencias significativas en cuanto a otros parámetros. Con respecto a TL, los pacientes con hipogonadismo tenían valores significativamente más altos de PCR (p=0,017), y TT guardó una correlación negativa con el índice de masa corporal (IMC), perímetro de la cintura, perímetro de la cadera, y niveles de PCR. TL se correlacionó negativamente con la edad, perímetro de cintura, presión arterial sistólica (PAS), presión arterial diastólica (PAD) y PCR.

Conclusiones

Se encontró frecuencia de hipogonadismo en cerca del 17-21% de los pacientes con IRC. A pesar de encontrar niveles similares de IL-6 y CIMT, los niveles de PCR fueron más altos en los pacientes con hipogonadismo. Consideramos que son necesarios más estudios, con poblaciones de mayor tamaño, para explicar esta entidad.

Palabras clave:
Aterosclerosis
Hipogonadismo
Inflamación
Insuficiencia renal crónica
Prediálisis

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