低血清睾酮与心脏移植术后早期移植物功能受损有关。

Low serum testosterone is associated with impaired graft function early after heart transplantation.

作者信息

Poglajen Gregor, Jensterle Mojca, Kravos Nika, Janež Andrej, Vrtovec Bojan

机构信息

Department of Cardiology, Advanced Heart Failure and Transplantation Center, University Medical Center Ljubljana, Ljubljana, Slovenia.

Department of Endocrinology and Metabolic Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia.

出版信息

Clin Transplant. 2017 Jun;31(6). doi: 10.1111/ctr.12970. Epub 2017 Apr 16.

DOI:10.1111/ctr.12970

PMID:28314079

Abstract

BACKGROUND

We sought to investigate a correlation between serum testosterone levels and graft function early after heart transplantation.

METHODS

In a cross-sectional study, we measured serum testosterone levels 4 weeks after heart transplantation in 49 consecutive male recipients. Echocardiography was carried out to evaluate graft function. Low serum testosterone was defined as <11 nmol/L.

RESULTS

Low serum testosterone was present in 21 (43%) recipients (Group A), and 28 (57%) had normal testosterone levels (Group B). The two groups did not differ in age and presence of renal dysfunction, arterial hypertension, diabetes, or hyperlipidemia. Donor age and allograft ischemic time were not different between the two groups. Both groups had comparable tacrolimus through levels, dose of mycophenolate mophetil, and methylprednisolone. Patients in Group A had significantly lower LVEF (58±5% vs 65±6% vs Group B, P=.001) and TAPSE (1.3±0.3 cm vs 1.6±0.3 cm in Group B, P=.01). In comparison with Group B, more patients in Group A were found to have low grade (1R) rejection (25% vs 3%; P=.02).

CONCLUSION

Low serum testosterone levels appear to be associated with impaired graft function and an increased incidence of low-grade rejection episodes early after heart transplantation.

摘要

背景

我们试图研究心脏移植术后早期血清睾酮水平与移植物功能之间的相关性。

方法

在一项横断面研究中，我们测量了49例连续男性受者心脏移植术后4周的血清睾酮水平。进行超声心动图检查以评估移植物功能。血清睾酮水平低定义为<11 nmol/L。

结果

21例（43%）受者血清睾酮水平低（A组），28例（57%）睾酮水平正常（B组）。两组在年龄以及是否存在肾功能不全、动脉高血压、糖尿病或高脂血症方面无差异。两组供体年龄和移植物缺血时间无差异。两组他克莫司血药浓度、霉酚酸酯剂量和甲泼尼龙相当。A组患者的左心室射血分数（LVEF）显著低于B组（58±5% 对 65±6%，P = .001），三尖瓣环平面收缩期位移（TAPSE）也显著低于B组（1.3±0.3 cm 对 1.6±0.3 cm，P = .01）。与B组相比，A组更多患者出现低级别（1R）排斥反应（25% 对 3%；P = .02）。