Association between Serum Testosterone Levels and Premature Coronary Artery Disease among Young Adult Males

Author(s): Bishojit Mondal, M. Atahar Ali, Shekhar Kumar Mondal, S.M Nazmul Huda, Atikur Rahman, Goutam Chandra Bhowmik, Tapan Chandra Shil, Md. Shamim Ahmed, Pijous Kumar Biswas, Md. Abu Zahid

Introduction: Prevalence of coronary artery (CAD) disease is increasing day by day among the young adult male population in Bangladesh. The most notable features of CAD in this population are the extreme prematurity and severity and 5-10-fold higher rates of myocardial infarction and death before the age of 40 years. There are a lot of modifiable and nonmodifiable risk factors for developing CAD in young adults. Male sex and male sex hormones are also important risk factors, but studies regarding the association with testosterone levels are done yet in our country. The aim of the study was to observe the possible association between serum testosterone levels and premature coronary artery disease.

Methods: This cross-sectional study was conducted at the Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh. The study duration was 1 year, from October 2018 to September 2019. A total of 100 cases were selected among the patients with Chronic Stable Angina (CSA) and Unstable Angina (UA) who underwent coronary angiography at the study hospital following the inclusion and exclusion criteria. The purposive sampling method was used for the selection of the participants, and the total participants were divided into two equal groups of 50 patients each, where Group 1 included 50 patients with low serum testosterone levels, and group 2 included 50 patients with normal serum testosterone levels.

Result: A total number of 100 patients were studied, divided into two equal groups of 50 cases in group I and 50 control in group II. The mean age of the studied patients was 39.9±5.2 years ranging from 26 to 45 years. The mean age of the group I patients were 39.9±5.9 years ranging from26 to 45 years and the mean age of the group II patients was 40.0±4.5 years ranging from 30 to 45 years. Mean serum testosterone level had decreased as the number of vessels involved increased in normal, single, double and triple vessel disease being 3.91, 2.65, 2.08, and 2.02 respectively and the difference was statistically significant (p<0.001).

Conclusion: This study found a link between testosterone levels and premature coronary artery disease in young adult males, and testosterone levels are connected with angiographic severity of premature coronary artery disease. Our findings show that decreased testosterone levels may be a new cardiovascular risk factor for developing early coronary artery disease.

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