Total testosterone levels, metabolic parameters, cardiac remodeling and exercise capacity in coronary artery disease patients with different stages of glucose tolerance

Figures & data

Table I. Medications of the patients by testos terone tertiles.

	Diabetics			Prediabetics			Controls
Study group	1st	2nd	3rd	1st	2nd	3rd	1st	2nd	3rd
Testosterone tertile
Age (years)	66.3 (0.7)	65.8 (0.7)	66.4 (0.7)	66.3 (0.9)	68.6 (0.9)	67.5 (0.9)	66.0 (0.8)	64.8 (0.8)	65.2 (0.8)
Current smokers, %	12	13	7	8	4	6	6	14	15
History of AMI	44	50	42	61	50	47	47	48	48
Medication
Antithrombotics	95	99	98	97	96	97	99	98	99
Beta-blockers	92	89	92	94	90	82	90	81	85
Calcium-channel blockers	42*	35	23	21	25	15	16	16	13
ACEI	47	50	43	53	38	39	44	35	39
AT2	24	27	22	24	15	18	13	25**	13
Diuretics	53*	47	31	29	13**	22	21	25	13
Lipid-lowering medication	90	93	93	94	93	93	91	92	91
Diet only for diabetes	12	15	22	–	–	–	–	–	–
Oral antidiabetic medication	53	57	56	–	–	–	–	–	–
Insulin	10	9	7	–	–	–	–	–	–
Insulin + oral antidiabetic medication	25	19	15	–	–	–	–	–	–
Nitrates	51	37**	41	25	40	26	37	21**	28

Values are mean (SE) or percentages.

*P < 0.01; *P < 0.05.

ACEI = angiotensin-converting enzyme inhibitor; AMI = acute myocardial infarction; AT2 = angiotensin II receptor blocker; BMI = body mass index.

Table II. Characteristics of the diabetic subjects (n = 489) according to the testosterone tertiles.

Testosterone tertile	1st		2nd		3rd
n	165		161		163		P ^a	P ^b
Age (years)	66.3	(0.7)	65.8	(0.7)	66.4	(0.7)	NS
Testosterone (nmol/L)	7.2	(0.2)	10.5	(0.2)	17.3	(0.2)	<0.001
BMI (kg/m^2)	31.4	(0.4)	29.8	(0.4)	28.4	(0.4)	<0.001	<0.001^c,d,e
Waist (cm)	110.7	(0.9)	106.2	(1.0)	101.8	(1.0)	<0.001	<0.03^c
Leptin (ng/mL)	2.5	(0.1)	1.6	(0.1)	1.4	(0.1)	<0.001	<0.001^c,d
Systolic BP (mmHg)	144.8	(1.8)	143.7	(1.8)	146.2	(1.8)	NS	NS
Diastolic BP (mmHg)	80.8	(0.9)	81.3	(0.9)	82.1	(0.9)	NS	NS
HbA1c (%)	7.4	(0.1)	7.0	(0.1)	6.8	(0.1)	<0.001	<0.01^c,d
Fasting glucose (mmol/L)	8.1	(0.2)	7.4	(0.2)	7.2	(0.2)	<0.01	<0.03^c,d
Fasting insulin (mU/L)	30.9	(6.6)	35.8	(6.6)	19.9	(6.6)	<0.001	<0.03^c
Total cholesterol (mmol/L)	3.8	(0.1)	3.7	(0.1)	3.9	(0.1)	NS	NS
HDL-cholesterol (mmol/L)	1.12	(0.02)	1.12	(0.02)	1.19	(0.02)	<0.03	NS
Triglycerides (mmol/L)	1.8	(0.1)	1.6	(0.1)	1.5	(0.1)	<0.01	NS

^aP values obtained from ANCOVA analyses before adjustment for age and BMI (except for BMI).

^bP values obtained from ANCOVA analyses after adjustment for age and BMI (except for BMI).

^c–e In post-hoc analyses significance between tertiles 1 and 3 (^c), 1 and 2 (^d), or 2 and 3 (^e).

Table III. Characteristics of the control subjects (n = 392) according to the testosterone tertiles.

Testosterone tertile	1st		2nd		3rd
n	133		129		130		P ^a	P ^b
Age (years)	66.0	(0.8)	64.8	(0.8)	65.2	(0.8)	NS
Testosterone (nmol/L)	9.7	(0.2)	14.3	(0.2)	21.2	(0.2)	< 0.001
BMI (kg/m^2)	27.4	(0.3)	26.9	(0.3)	25.7	(0.3)	< 0.001	< 0.001^c
Waist (cm)	99.2	(0.8)	97.2	(0.8)	93.6	(0.8)	< 0.001	< 0.01^c
Leptin (ng/mL)	1.3	(0.2)	1.2	(0.2)	0.8	(0.2)	< 0.001	< 0.03^c
Systolic BP (mmHg)	142.8	(2.0)	145.8	(2.1)	143.2	(2.1)	NS	NS
Diastolic BP (mmHg)	80.9	(0.9)	82.0	(0.9)	80.9	(0.9)	NS	NS
HbA1c (%)	5.83	(0.03)	5.83	(0.03)	5.77	(0.03)	NS	NS
Fasting glucose (mmol/L)	5.54	(0.04)	5.35	(0.04)	5.32	(0.04)	< 0.001	< 0.001^c,d
Fasting insulin (mU/L)	11.9	(0.5)	9.9	(0.5)	8.9	(0.5)	< 0.001	< 0.01^c,d
Total cholesterol (mmol/L)	3.8	(0.1)	3.9	(0.1)	4.1	(0.1)	NS	NS
HDL-cholesterol (mmol/L)	1.16	(0.02)	1.28	(0.02)	1.33	(0.02)	< 0.001	< 0.001^c,d
Triglycerides (mmol/L)	1.30	(0.05)	1.12	(0.05)	1.07	(0.05)	< 0.01	< 0.03^c,d

^aP values obtained from ANCOVA analyses before adjustment for age and BMI (except for BMI).

^bP values obtained from ANCOVA analyses after adjustment for age and BMI (except for BMI).

^c,dIn post-hoc analyses significance between tertiles 1 and 3 (^c), or 1 and 2 (^d).

Table IV. Characteristics of the prediabetic subjects (n = 216) according to the testosterone tertiles.

Testosterone tertile	1st		2nd		3rd
n	72		72		72		P ^a	P ^b
Age (years)	66.3	(0.9)	68.9	(0.9)	67.5	(0.9)	NS
Testosterone (nmol/L)	8.8	(0.3)	13.3	(0.3)	20.6	(0.3)	< 0.001
BMI (kg/m^2)	28.4	(0.4)	26.5	(0.4)	27.0	(0.4)	< 0.01	< 0.03^d
Waist (cm)	103.5	(1.2)	97.6	(1.2)	97.0	(1.2)	< 0.001	< 0.01^c
Leptin (ng/mL)	1.7	(0.2)	1.0	(0.2)	1.3	(0.2)	< 0.05	NS
Systolic BP (mmHg)	144.9	(2.7)	144.8	(2.7)	150.3	(2.7)	NS	NS
Diastolic BP (mmHg)	81.0	(1.4)	79.7	(1.4)	82.5	(1.4)	NS	NS
HbA1c (%)	6.02	(0.06)	5.86	(0.06)	5.91	(0.06)	NS	NS
Fasting glucose (mmol/L)	6.02	(0.07)	6.02	(0.07)	6.03	(0.07)	NS	NS
Fasting insulin (mU/L)	14.2	(0.8)	10.9	(0.8)	12.4	(0.8)	< 0.03	NS
Total cholesterol (mmol/L)	3.8	(0.1)	3.9	(0.1)	4.0	(0.1)	NS	NS
HDL-cholesterol (mmol/L)	1.16	(0.03)	1.20	(0.03)	1.29	(0.03)	< 0.05	< 0.03^c
Triglycerides (mmol/L)	1.39	(0.08)	1.23	(0.08)	1.20	(0.08)	NS	NS

^aP values obtained from ANCOVA analyses before adjustment for age and BMI (except for BMI).

^bP values obtained from ANCOVA analyses after adjustment for age and BMI (except for BMI).

^c,dIn post-hoc analyses significance between tertiles 1 and 3 (^c), or 1 and 2 (^d).

Table V. Echo parameters and maximal exercise capacity during exercise test in the diabetic subjects according to the testosterone tertiles.

Testosterone tertile	1st		2nd		3rd		P^a	P^b
LVMI (g/m^2)	115.4	(2.2)	110.3	(2.2)	108.6	(2.2)	< 0.05^c	–
EF (%)	61.9	(0.8)	63.2	(0.8)	63.3	(0.8)	NS	NS
E/E’	11.7	(4.4)	10.3	(3.3)	10.8	(3.8)	< 0.01	< 0.01^d
E/A	1.08	(0.04)	1.02	(0.04)	1.10	(0.03)	NS	NS
IVRT (ms)	102.1	(2.0)	96.8	(2.0)	101.5	(2.0)	NS	NS
Septal wall (mm)	12.4	(0.17)	11.6	(0.17)	11.5	(0.17)	< 0.001	< 0.03^c,d
Max watts during exercise test	119.7	(2.9)	128.7	(2.9)	135.0	(2.9)	< 0.001	< 0.001^c
Max METs during exercise test	4.6	(0.1)	5.1	(0.1)	5.6	(0.1)	< 0.001	< 0.001^c,e

^a,bP values obtained from ANCOVA analyses adjusted for age, systolic blood pressure, and heart rate (^a) or age, systolic blood pressure, heart rate, and BMI (^b). LVMI was not adjusted for BMI. Maximal exercise capacity adjusted for age (^a) or age and BMI (^b).

^c–eIn post-hoc analyses significance between tertiles 1 and 3 (^c), 1 and 2 (^d), or 2 and 3 (^e).

EF = LV ejection fraction; IVRT = isovolumic relaxation time; LVMI = left ventricular mass index; MET = metabolic equivalent.

Table VI. Echo parameters and maximal exercise capacity during exercise test in the control subjects according to the testosterone tertiles.

Testosterone tertile	1st		2nd		3rd		P ^a	P ^b
LVMI (g/m^2)	110.6	(2.3)	108.9	(2.3)	110.6	(2.3)	NS
EF (%)	64.4	(0.7)	63.9	(0.7)	62.8	(0.7)	NS	NS
E/E’	9.9	(0.3)	9.8	(0.3)	9.3	(0.3)	NS	NS
E/A	1.18	(0.04)	1.11	(0.04)	1.17	(0.04)	< 0.03	< 0.03
IVRT (ms)	103.6	(1.9)	103.8	(1.9)	101.5	(1.9)	NS	NS
Septal wall (cm)	1.12	(0.02)	1.10	(0.02)	1.08	(0.02)	NS	NS
Max watts during exercise test	141.8	(3.3)	152.3	(3.4)	147.6	(3.4)	NS	NS
Max METs during exercise test	6.0	(0.1)	6.6	(0.1)	6.7	(0.1)	< 0.01	< 0.03

^a,b P values obtained from ANCOVA analyses adjusted for age, systolic blood pressure, and heart rate (^a), or age, systolic blood pressure, heart rate, and BMI (^b). LVMI was not adjusted for BMI. Maximal exercise capacity adjusted for age (^a), or age and BMI (^b).

Table VII. Echo parameters and maximal exercise capacity during exercise test in the prediabetic subjects according to the testosterone tertiles.

Testosterone tertile	1st		2nd		3rd		P^a	P^b
LVMI (g/m^2)	108.4	(3.7)	115.9	(3.7)	110.5	(3.7)	NS
EF (%)	63.7	(1.1)	63.0	(1.1)	66.0	(1.1)	NS	NS
E/E’	9.5	(0.3)	10.0	(0.3)	9.7	(0.3)	NS	NS
E/A	1.08	(0.04)	1.08	(0.04)	1.10	(0.04)	NS	NS
IVRT (ms)	100.2	(2.9)	104.2	(2.9)	98.4	(2.9)	NS	NS
Septal wall (cm)	11.3	(0.2)	11.4	(0.2)	11.4	(0.2)	NS	NS
Max watts during exercise test	124.7	(2.6)	124.2	(2.6)	130.7	(2.6)	NS	NS
Max METs during exercise test	5.7	(0.2)	6.0	(0.2)	6.1	(0.2)	NS	NS

^a,b P values obtained from ANCOVA analyses adjusted for age, systolic blood pressure, and heart rate (^a), or age, systolic blood pressure, heart rate, and BMI (^b). LVMI was not adjusted for BMI. Maximal exercise capacity adjusted for age (^a), or age and BMI (^b).