Poliwczak Adam R, Tylińska Maja, Broncel Marlena
Pol Arch Med Wewn. 2013;123(9):467-73. doi: 10.20452/pamw.1887. Epub 2013 Aug 19.
Testosterone deficiency syndrome (TDS) is characterized by clinical signs of testosterone deficiency in men with reduced testosterone levels. It leads to endothelial dysfunction, which, apart from erectile dysfunction, accelerates atherosclerosis progression.
The aim of the study was to evaluate the effect of testosterone supplementation in men with metabolic syndrome (MS) and TDS on autonomic balance assessed by heart rate variability (HRV) in 24‑hour Holter monitoring.
The study included 80 men divided into 3 groups: with MS and TDS (MS+TDS+, n = 30), with MS and without TDS (MS+TDS-, n = 25), and healthy controls (n = 25). The MS+TDS+ group received intramuscular testosterone therapy (Omnadren 250) for 9 weeks. Holter monitoring was performed in all patients at baseline and at the end of the therapy.
Almost all HRV parameters were significantly lower in the MS+TDS+ group compared with controls. Moreover, total power (TP) as well as high- and low‑frequency domains (HF and LF, respectively) were significantly lower in the MS+TDS+ group compared with the MS+TDS- group. There were significant differences in the standard deviation (SD) of normal-to-normal (NN) intervals (SDNN), SDNN index (SDNNI), and SDANN (SD of the averages of NN intervals in all 5‑minute segments) as well as in ultra‑low‑frequency (ULF) domain between the MS+TDS- group and controls. Testosterone supplementation resulted in a statistically significant increase in SDNN, SDANN, TP, LF, ULF, and very‑low‑frequency domain. However, the values did not reach those observed in the control group. The levels of total and free testosterone were not significantly affected by the treatment.
A 9‑week testosterone supplementation therapy improves HRV parameters. Although these parameters did not reach the values observed in healthy men, the therapy may reduce cardiovascular risk in men with MS and TDS.
睾酮缺乏综合征（TDS）的特征是睾酮水平降低的男性出现睾酮缺乏的临床症状。它会导致内皮功能障碍，除了勃起功能障碍外，还会加速动脉粥样硬化的进展。
本研究的目的是评估睾酮补充剂对患有代谢综合征（MS）和TDS的男性自主神经平衡的影响，通过24小时动态心电图监测中的心率变异性（HRV）进行评估。
该研究纳入了80名男性，分为3组：患有MS和TDS（MS+TDS+，n = 30）、患有MS但无TDS（MS+TDS-，n = 25）以及健康对照组（n = 25）。MS+TDS+组接受了9周的肌肉注射睾酮治疗（Omnadren 250）。所有患者在基线和治疗结束时均进行了动态心电图监测。
与对照组相比，MS+TDS+组几乎所有的HRV参数均显著降低。此外，与MS+TDS-组相比，MS+TDS+组的总功率（TP）以及高频和低频域（分别为HF和LF）均显著降低。MS+TDS-组与对照组之间在正常到正常（NN）间期的标准差（SDNN）、SDNN指数（SDNNI）和SDANN（所有5分钟段中NN间期平均值的标准差）以及超低频（ULF）域方面存在显著差异。睾酮补充剂导致SDNN、SDANN、TP、LF、ULF和极低频域在统计学上显著增加。然而，这些值未达到对照组中观察到的值。治疗对总睾酮和游离睾酮水平没有显著影响。
为期9周的睾酮补充疗法可改善HRV参数。尽管这些参数未达到健康男性中观察到的值，但该疗法可能会降低患有MS和TDS的男性的心血管风险。
