男性患者中睾酮与心肌梗死及冠状动脉疾病严重程度的关联
Association of testosterone with myocardial infarction and severity of coronary artery disease among male patients.
作者信息
Tang Lujing, Chen Mengsha, Li Jiahao, Xu Xiaodong, Pu Xiangyuan
机构信息
Department of Gastroenterology, The Children's Hospital Zhejiang University School of Medicine, China.
School of Public Health, Zhejiang University School of Medicine, China.
出版信息
Int J Cardiol Cardiovasc Risk Prev. 2024 May 7;21:200281. doi: 10.1016/j.ijcrp.2024.200281. eCollection 2024 Jun.
BACKGROUND
Coronary heart disease (CHD) remains a leading cause of morbidity and mortality, particularly in aging populations. Men typically exhibit higher rates of CHD compared to women, with testosterone levels inversely associated with cardiovascular risk. This study investigates the relationship between testosterone levels and angiographically confirmed CHD, disease severity, and myocardial infarction (MI) among CHD cases.
METHODS
A cohort of 1724 male patients undergoing diagnostic or interventional coronary angiography was examined. Demographic, clinical, and biochemical data were collected, including serum total testosterone levels. The severity of CHD was assessed using the Gensini score, and MI cases were diagnosed according to World Health Organization criteria.
RESULTS
Results revealed significant differences in testosterone levels among CHD subtypes, particularly between MI and unstable angina/stable angina groups (p < 0.001). Testosterone levels were inversely correlated with CHD severity, as evidenced by the Gensini score (Pearson coefficient = -0.062, P = 0.004). Cross-validation random forest analysis demonstrated the significant contribution of testosterone to CHD severity discrimination (p < 0.05).
CONCLUSIONS
There is an association between testosterone and a predisposition to severe CAD indicated by Gensini score and myocardial infarction.
背景
冠心病（CHD）仍然是发病和死亡的主要原因，尤其是在老年人群中。与女性相比，男性通常表现出更高的冠心病发病率，睾酮水平与心血管风险呈负相关。本研究调查了冠心病患者中睾酮水平与血管造影确诊的冠心病、疾病严重程度及心肌梗死（MI）之间的关系。
方法
对1724例接受诊断性或介入性冠状动脉造影的男性患者进行了研究。收集了人口统计学、临床和生化数据，包括血清总睾酮水平。使用Gensini评分评估冠心病的严重程度，并根据世界卫生组织标准诊断心肌梗死病例。
结果
结果显示，冠心病各亚型之间的睾酮水平存在显著差异，尤其是心肌梗死组与不稳定型心绞痛/稳定型心绞痛组之间（p < 0.001）。睾酮水平与冠心病严重程度呈负相关，Gensini评分证明了这一点（Pearson系数 = -0.062，P = 0.004）。交叉验证随机森林分析表明，睾酮对冠心病严重程度的鉴别有显著贡献（p < 0.05）。
结论
睾酮与Gensini评分和心肌梗死所表明的严重冠状动脉疾病易感性之间存在关联。
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