Association Of Serum Androgen Level With Cytokines And Activator Protein-1 In Male Chronic Heart Failure Patients

Objective: By comparing men with heart failure(HF) patients and healthy male serum androgen,cytokines and activator protein-1(AP-1) levels of change, analysis of relevant cytokines and AP-1 and androgen.Explore male serum androgen levels in patients with heart failure, cytokines and AP-1 changes, and heart failure as well as the relationship, to provide a theoretical basis for the clinical treatment of male androgen in patients with heart failure.Methods: HF patients comes since July 2011 to December 2013 Tianjin First Central Hospital of patients hospitalized male 160 cases, all patients selected by echocardiogram examination showed LVEF ≦ 45%. Select the hospital earlier examination of 40 healthy males, were confirmed by biochemical, chest X-ray,electrocardiogram, echocardiogram and other tests proved to be healthy. HF group and the healthy group Exclusion criteria: no connective tissue disease, cancer history of recent infection and disease, and not used hormone therapy. Record all the subjects of the following clinical data: age, weight, smoking history, hypertension, atrial fibrillation, diabetes, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, the overnight fasting after 12 h 7:00in the morning were taken cubital vein 8ml, 8ml, 5ml, serum free testosterone(FT)using ELISA,as well total testosterone(TT), dehydro-epiandrosterone(DHEA),dehydro-epiandrosterone sulfate( DHEAS), interleukin-1β( IL-1β), interleukin-6(IL-6), tumor necrosis factor(TNF-ɑ), interleukin-10(IL-10) and AP-1 levels.Statistical Methods: Analyse the data used the statistic software SPSS 13.0. Scale data were expressed with mean±sd, followed T test was used to compare scale data between groups, Chi square test were used to count data.We used Tukey method pairwise comparisons, respectively comparison of HF group and the control group androgen levels, AP-1 and cytokine levels. HF group using univariate analysis of relevant cytokines and AP-1 and androgen, using multivariate analysis screening AP-1 impacts. P <0.05 was regarded as the difference has statistical significance.Result: 1. Compared with the control group, patients with heart failure group of men FT, TT, DHEA and DHEAS levels decline, reduced heart function and increase thegrade(P<0.05 or P<0.01).2.Heart failure patients IL-1β, IL-6, TNF-ɑ and AP-1levels were significantly higher, and increase heart function classification rises; IL-10 was significantly lower than the control group, and heart function classification increases(P<0.05 or P<0.01).3, Univariate analysis showed correlation with heart failure group FT, TT, DHEA and DHEAS and IL-1β, IL-6, TNF-ɑ and AP-1 was negatively correlated, positively correlated with IL-10 was( P<0.05 or P<0.01).4.Multiple regression analysis showed that hypertension, diabetes, atrial fibrillation and FT independently associated with AP-1.Conclusion:1.Lower androgen levels in the blood of patients with heart failure, and androgen reduce the severity of heart failure in patients with the disease affects men.2.The pathological process of heart failure, the proinflammatory and anti-inflammatory cytokines balance disorders, anti-inflammatory cytokines can not fight proinflammatory cytokine-mediated myocardial injury.3.Male patients with heart failure to reduce androgen, could not suppress proinflammatory cytokine secretion, the relative lack of anti-inflammatory cytokines,effect the development and progression of heart failure.