Thursday, April 30, 2009

How is Testosterone related with Cardiometabolic Risks?

Certain risk factors have been shown to cluster with clinical conditions like obesity, type 2 diabetes and cardiovascular problems. Such clustering of risk factors have led investigators to propose a new condition called cardiometabolic risk syndrome. Cardiometabolic risk has gained much attention recently and has been linked directly with visceral adiposity. Few investigations have implicated a direct link between centrally obese men and low levels of testosterone. Association of Testosterone with insulin resistance, obesity, diabetes and atheroschlerosis has been presented earlier but has not received much attention. Higher incidence of metabolic syndrome has also been hypothesized to be associated with decline in testosterone levels. There is evidence that testosterone replacement therapy results in reduced insulin resistance and central obesity in type 2 diabetic men. In this study, we have investigated relationship between testosterone and markers of cardiometabolic risk.

A cohort of male patient samples from ZRT database was selected for the study and categorized in tertiles based on testosterone levels with low (<300),>800). The relationship between testosterone levels and cardiometabolic risk was evaluated using bloodspot testing of insulin, hemoglobin A1c, triglycerides and high sensitivity c-reactive protein. All bloodspot assays were developed in house and showed good correlations with serum/plasma levels of risk markers tested.

A total of 124 male patient samples (41 with testosterone levels <>800 ng/dL) were tested for cardiometabolic risk markers. Mean age (+/- SD) was 50.8 (+/- 12.8). Insulin (4.7 µIU/mL) and high sensitivity c-reactive protein (1.83 mg/L) were found to be significantly lower in the highest tertile with testosterone levels greater than 800 ng/dL when compared with insulin (6.3 µIU/mL) and hs-CRP (3.46 mg/L) concentrations in the lowest tertile with testosterone levels less than 300 ng/dL. There was no significant difference observed in HbA1c and triglyceride levels in different groups.

Our data suggest that a higher testosterone level in men is associated with lower CRP and insulin concentrations. These patients may have a lower risk of developing metabolic syndrome and/or atheroschlerotic cardiovascular events.

Thursday, April 2, 2009

How does stress level affect overall risk of getting heart disease?

Stress and depression, both have been linked with diabetes and heart disease. Understanding these two factors can actually help our doctor formulate a suitable treatment plan. So, it is important that we share this with our health care provider even if they forget to ask. Any kind of stress or depression can lead to more complications, if left untreated.

Stress causes release of some hormones which can further lead to elevated blood glucose levels. When the blood glucose levels increase and if there is not enough insulin being produced by the body or if the insulin is not working properly, then this results in excessive glucose in the blood, which can ultimately lead to development of diabetes.

Stress can come from many sources, including stress from one’s occupation, job strain especially in this economy as we are going through recession; many of us are losing jobs, homes, which is very sad and unfortunate. So, this stress can cause increased production of a stress hormone called cortisol, which then makes the liver produce more glucose, which means more glucose in blood and less usage of glucose by the tissues, less insulin production by our pancreas, thereby causing a condition called insulin resistance. This insulin resistance can finally lead to diabetes and/ or heart disease.

It is extremely important to maintain blood glucose levels, especially in diabetics and this can be done through stress management training. Sharing the cause of stress with the primary care doctor, family or friends is always helpful. Sometimes, social support can reduce the stress and this way it can reduce the risk of heart disease.

Similarly, depression causes several changes in our hormones thereby leading to a hormone imbalance, can decrease body’s immunity; can affect changes in bone metabolism; and can cause cardiovascular dysfunction. This can result in decreased quality of life. People living under any kind of depression are at higher risk of getting type 2 diabetes or heart disease.

What should be done to avoid becoming a victim of conditions like stress and depression?

Hormone balance, in addition to healthy diet and exercise, is the answer. Hormones affect everyday health and wellness by interacting with every single cell inside our bodies, and if these do not do their job well, a negative ripple effect is created thereby disrupting overall homeostasis resulting in damaged and disturbed physiology. Therefore, it has been suggested by various published scientific studies that keeping the hormone levels of the body in proper balance within the normal ranges helps in reducing risk of getting diagnosed with conditions like heart disease and diabetes.