ABSTRACT
UNLABELLED: Abstract Background: The ATPIII criteria of the metabolic syndrome (MS) comprise impaired fasting glucose (>5.6 nmol/L), waist circumference >102 cm, hypertension (>130/85 mm Hg), high triglycerides (>1.7 nmol/L) and low HDL cholesterol (≤1.03 nmol/L). Aldosterone is currently recognized as a key factor in the pathogenesis of cardiovascular diseases and insulin resistance, linking hypertension to MS and obesity. Further, the MS is related to psychological functioning. MATERIALS AND METHODS: Forty-two men older than 40 years with BMI >30 kg/m2, chronic heart failure (CHF) and serum testosterone (T) <12.0 nmol/L were recruited. Of these 42, 26 consented to T treatment and received two injections with T undecanoate 1000 mg. Biochemical variables relevant for the MS and also serum aldosterone were determined before and after injections; an echocardiography and Aging Males' Symptoms (AMS) scale were also utilized. RESULTS AND CONCLUSIONS: After 24 weeks of testosterone administration, there were significant declines of insulin and homeostatic model assessment and of serum aldosterone, but no changes in blood pressure. Serum glucose declined but not significantly (p=0.073). There was a slight increase in LDL cholesterol and a decrease in triglycerides. Other variables of MS and other biochemical variables did not change. Echocardiographical variables did not change. The AMS showed improvements over the first 3 months after testosterone administration but, although sustained, there was no further improvement. Short-term testosterone administration over 24 weeks led to some improvements of variables of the MS, notably of aldosterone. Longer-term studies are needed to analyze whether the decrease in serum aldosterone will improve blood pressure and glycemic control.
ABSTRACT
The accurate measurement of testosterone remains a challenge. The determination of the blood testosterone concentrations in serum by conventional immunoassays is inaccurate in men and even more so in females and children. A new luminescence enzyme immunoassay (LIA) has been developed and validated. The high analytical (8.7 pmol/L) and functional (17.3 pmol/L) sensitivity allows the quantification of the very low concentration in saliva, as well as in serum, after 1/40 dilution. This study measured salivary testosterone levels and compared the results with the free levels calculated from total testosterone and sex hormone-binding globulin in eugonadal and hypogonadal men. Salivary testosterone concentrations in healthy men in morning hours were 369 pmol/L (mean), range 263-544 pmol/L, which was statistically significantly higher than that in men with androgen deficiency, 215 pmol/L (mean), range 51-249 pmol/L. Repetitive determination of free testosterone concentrations in saliva (once a week for 5 weeks) showed high stability of results over time, with coefficient of variation 9% (range 5-23%). In this study we showed that free salivary testosterone levels in morning samples correlated well with calculated free testosterone in blood, both in healthy men (R = 0.754, P = 0.001), and in patients with androgen deficiency (R = 0.889, P = 0.0001), though in cases with very low testosterone, salivary concentrations were systematically higher than calculated free testosterone levels in blood.