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Effect of Testosterone on Natriuretic Peptide Levels
Katherine N Bachmann1, Shi Huang2, Hang Lee3
1Veterans Administration Tennessee Valley Healthcare System, Nashville, Tennessee; Division of Diabetes, Endocrinology, and Metabolism, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University School of Medicine, Nashville, Tennessee.
Journal of the American College of Cardiology
|March 23, 2019
Summary
Lower testosterone in men is linked to higher natriuretic peptide (NP) levels. Testosterone replacement therapy can attenuate these increases, suggesting testosterone influences NP production and may explain lower NP levels in men.
Area of Science:
- Endocrinology
- Cardiovascular Science
- Men's Health
Background:
- Circulating natriuretic peptide (NP) levels are significantly lower in healthy men compared to women.
- This sex-specific difference in NP levels may contribute to the higher prevalence of hypertension and cardiovascular disease in men.
- Epidemiological data suggests a potential role for testosterone in mediating these observed sex differences in NP levels.
Purpose of the Study:
- To investigate the direct impact of testosterone administration on natriuretic peptide levels in men.
- To determine if testosterone replacement can counteract the effects of testosterone suppression on NP levels.
Main Methods:
- A randomized, placebo-controlled trial involving 151 healthy men aged 20-50 years.
- Participants received goserelin acetate and anastrazole to suppress endogenous gonadal steroids.
- Subjects were randomized to receive either placebo gel or one of four doses of testosterone gel for 12 weeks, with serum NT-proBNP and testosterone levels measured.
Main Results:
- Suppression of endogenous testosterone led to a significant increase in N-terminal-pro-B-type natriuretic peptide (NT-proBNP) levels.
- Testosterone replacement therapy demonstrated a dose-dependent attenuation of NT-proBNP levels.
- A decrease in serum testosterone was associated with a predicted increase in NT-proBNP, while testosterone replacement attenuated this effect.
Conclusions:
- Testosterone suppression in men results in elevated circulating NT-proBNP levels.
- Testosterone replacement therapy mitigates the increase in NT-proBNP, indicating testosterone's inhibitory effect on NP production.
- This finding supports the hypothesis that testosterone contributes to lower NP levels in men, potentially influencing cardiovascular risk.
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