GULHANE MEDICAL JOURNAL 2017 , Vol 59 , Issue 1
Assessment of a low ankle brachial index in young males with congenital hypogonadism
Cem Haymana1,Aydogan Aydogdu1,Ilker Tasci2,Umut Safer3,Tural Ibrahimov1,Mustafa Dinc1,Fatih Yesildal4,Serkan Tapan5,Kayıhan Kara3,Coskun Meric1,Omer Azal1
1Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, Ankara, Turkey
2Department of Internal Medicine, Gulhane Training and Research Hospital, Ankara, Turkey
3Haydarpaşa Sultan Abdulhamit Training and Research Hospital, Istanbul, Turkey
4Department of Biochemistry, Selahaddin Eyyubi Public Hospital, Diyarbakır, Turkey
5Department of Biochemistry, Yuksek Ihtisas University, Ankara, Turkey
DOI : 10.5455/gulhane. 252515 Cardio-metabolic diseases are prevalent in hypogonadism. Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis and is a well-known predictor of coronary heart disease and stroke. This study investigated whether young and treatment naïve hypogonadal patients had higher frequency of PAD and were under increased risk of systemic atherosclerosis. The study included 49 patients with congenital hypogonadotrophic hypogonadism (CHH) (mean age: 21.82 ± 2.28 years) and 37 healthy control subjects (mean age: 22.34 ± 1.20 years). Blood asymmetric dimethylarginine (ADMA) and high-sensitivity C-reactive protein (hs-CRP) were measured, and insulin resistance was calculated using homeostatic model assessment of insulin resistance (HOMA-IR) score. PAD was determined by the ankle brachial index (ABI) using Doppler technique. Patients with CHH had higher total cholesterol (p=0.038), triglyceride (p=0.047), insulin (p<0.001), HOMA-IR score (p<0.001) and ADMA (p<0.001), and lower body mass index (p=0.001) and systolic blood pressure (p<0.007), compared to healthy controls. Mean ABI value was 1.05 ± 0.13 in patients and 1.00 ± 0.10 in controls (NS). Based on a low ABI, 12.2% of patients and 13.5% of controls had lower extremity PAD (NS). However, in the multivariable model none of the study parameter was a predictor of a low ABI. Young and treatment naive patients with CHH had increased dysmetabolic features such as endothelial dysfunction and insulin resistance but did not have increased frequency of a low ABI compared to controls. ABI measurement might not be a sensitive tool to detect PAD in young male patients with hypogonadism. Keywords : Hypogonadism; Ankle brachial index; Endothelial dysfunction; Peripheral arterial disease