Charbit Beny, Christin-Maître Sophie, Démolis Jean-Louis, Soustre Elsa, Young Jacques, Funck-Brentano Christian
Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France.
Am J Cardiol. 2009 Mar 15;103(6):887-90. doi: 10.1016/j.amjcard.2008.11.041. Epub 2009 Jan 24.
QT-interval duration is shorter in men than in women. Estrogens do not significantly influence the duration of repolarization. The effect of testosterone has not been studied directly in humans. The aim of this study was to assess the effects of testosterone on corrected QT duration in hypogonadic men. Eleven hypogonadic men were enrolled in this prospective interventional study. Digital electrocardiograms were recorded for each participant at 3 levels of testosterone, high, medium, and low, after a single intramuscular administration of testosterone. Heart rate-independent assessment of QT-interval duration was used. QT(1,000) (QT at 60 beats/min) was determined for each subject. Total blood testosterone and the ratio of testosterone to sex hormone-binding globulin were assessed at each visit. The median values of QT(1,000) were 352 ms (interquartile range 340 to 363), 357 ms (interquartile range 349 to 367), and 363 ms (interquartile range 357 to 384) at high, medium, and low testosterone concentrations, respectively (p <0.013 for the 3 comparisons). A maximal mean difference of 13.6 +/- 2.8 ms (p = 0.0007) was observed between high and low levels of testosterone. A negative linear relation was found between QT(1,000) and testosterone concentration (p = 0.0001) or the ratio of testosterone to sex hormone-binding globulin (p = 0.004). In conclusion, the difference in QT-interval duration between men and women might be explained by differences in testosterone levels, and testosterone shortens ventricular repolarization.
男性的QT间期持续时间比女性短。雌激素对复极化持续时间没有显著影响。睾酮对人类的影响尚未直接进行研究。本研究的目的是评估睾酮对性腺功能减退男性校正QT间期的影响。11名性腺功能减退男性参与了这项前瞻性干预研究。在单次肌肉注射睾酮后，对每位参与者在高、中、低三个睾酮水平下进行数字心电图记录。采用心率独立的QT间期持续时间评估方法。为每位受试者测定QT(1,000)（60次/分钟时的QT）。每次就诊时评估总血睾酮以及睾酮与性激素结合球蛋白的比值。在高、中、低睾酮浓度下，QT(1,000)的中位数分别为352毫秒（四分位间距340至363）、357毫秒（四分位间距349至367）和363毫秒（四分位间距357至384）（三组比较，p<0.013）。在高和低睾酮水平之间观察到最大平均差异为13.6±2.8毫秒（p = 0.0007）。发现QT(1,000)与睾酮浓度（p = 0.0001）或睾酮与性激素结合球蛋白的比值（p = 0.004）之间呈负线性关系。总之，男性和女性之间QT间期持续时间的差异可能由睾酮水平的差异来解释，并且睾酮可缩短心室复极化。
