The Relationship Between Plasma Total Testosterone And Vascular Endothelial Function In Male Hypertensives

Background: Hypertension and cardio-cerebrovascular complications alwaysmanifest a tendency of early-onset and multiple in male. Occurrence or progress ofhypertension, endothelial dysfunction and atherosclerosis are closely association withendogenous testosterone deficiency. Men may be at high onset or mortality risk ofcardio-cerebrovascular disease because of endogenous testosterone deficiency.Meanwhile, the reactive hyperemia index(RHI) from Endo-PAT2000noninvasivedetermination of peripheral arterial tension become a reliability index of endothelialfunction、cardiovascular events.Objective: To observe concentration variation of plasma total testosterone(PTT)in male hypertensives; To discuss the relationship between PTT and endothelialfunction or traditional cardiovascular risk factors..Methods: The study continuedly enrolled188male hypertensives and31healthy men from the second affiliated hospital of Nanchang university betweenMay,2013and Dec,2013.Patients are divided into hypertension class1(24individuals,mean age58.83±12.14), hypertension class2(42individuals, mean age59.64±11.210),hypertension class3(122individuals, mean age59.39±11.32),controlgroup(31healthy men, mean age58.19±8.24). Meanwhile,188male hypertensivesare divided into low concentration group and hihg concentration group according tomedian of PTT. We also recorded age, body mass index(BMI),history of smokin,history of diseases and medication, and detectted PTT, estradiol, fasting bloodglucose(FBS), glycated hemoglobin, blood lipid(triglyceride TG, total cholesterolTC,low density lipoprotein LDL-C, high density lipoprotein HDL-C,apolipoproteinA1apoA1,apolipoproteinB apoB, lipoprotein LP), homocysteine(Hcy), high-sensitivity C-reactive protein(hs-CRP).The Endo-PAT2000noninvasivetesting equipment of vascular endothelial function measured RHI which evaluatevascular endothelial function.Results:(1)PTT and estradiol concertration in male hypertensives significantly lower than healthy men[13.72±4.93nmol/lVS18.39±3.02nmol/l，P＜0.01],[121.88±48.41pmol/lVS158.29±50.24pmol/l，P＜0.01]; PTT gradually declined[18.39±3.02nmol/lVS16.62±5.21nmol/lVS14.11±4.31nmol/lVS13.02±4.88nmol/l，P＜0.01] with elevation of blood pressure(control group，hyperten class1，hyperten class2，hyperten class3）. However, the difference of estradiol concertration was notstatistically significant in male hypertensives（P＞0.05）.The pearson correlationbetween PTT and cardiovascular risk factors showed that BMI (r=-0.272,P＜0.01),FBS(r=-0.211,P＜0.01),lghs-CRP(r=-0.282,P＜0.01),lgTG(r=-0.164,P＜0.05),smoking（r=-0.160,P＜0.05）,diabetes or abnormal glucose tolerance(r=-0.147,P＜0.05) were negative correlation; homocysteine(r=0.147,P＜0.05), diuretic(r=0.220,P＜0.05) were positive correlation. Multiple linear regression analysis showed thatBMI, smoking, hyertension classification and FBS were linearly associated with PTT.RHI gradually decline[1.77±0.42VS1.59±0.39，P＜0.01] with falling of PTT.The pearson correlation analysis indicated that RHI was positive correlation withPTT[r=0.222，P＜0.01], lghs-CRP[r=-0.283，P＜0.01],cardiovascular events[r=-0.258，P＜0.01] were negative correlation with RHI. Meanwhile, multiple linearregression analysis showed that lghs-CRP, cardio-cerebrovascular events, PTTwere linearly associated with RHI.Conclusion: PTT concentration was lower than healthy man, and it graduallydeclined with elevation of blood pressure in male hypertensives. RHI decreased withdeclining of the endogenous PTT, and were independently positive correlation withPTT, which suggestted that the lack of endogenous testosterone may be associatedwith endothelial dysfunction. Meanwhile, between RHI and cardio-cerebrovascularcomplications were negative correlation, which hinted that endothelial injury maypredict more vascular events in male hyertensives.