During aging there is a decrease of anabolic hormones. Furthermore surgical procedures like CABG (coronary artery bypass graft) induce hormonal changes with an imbalance between anabolic and catabolic spurts. The aim of the study was to investigate the modifications of some hormones in old patients undergoing CABG. We studied 19 patients (12 males , 7 females) aged 70+-6 years (mean +-SD), with a mean BMI of 26,4+-3,8, affected by ischemic cardiomyopathy (NYHA class of 3.5) with an EF <40%.The mean score of comorbidity class(according Greenfield)was 2,55. CABG mean duration was 4.5 hours. Blood samples were collected: 1 day before, the day of the operation, after the anaesthetic induction, at 1,2,3,4 days ,1 and 3 months after. Total testosterone, SHBG, GH, IGF-1, cortisol, DHEA and DHEAS were measured with IRMA. Immediately after surgery and for the first week, there was a significant decrease of IGF-1. Similar results were observed for SHBG. Testosterone levels showed a gender-related pattern of secretion; in males there was a significant decrease lasting for the first week while in females there was a consistent increase. Cortisol, DHEA and DHEAS followed a similar pattern induced by the surgical stress with an unmodified cortisol/DHEA-DHEAS molar ratio. GH was slightly increased for the first 2-3 days. This hormonal pattern worsens the metabolic imbalance due to aging per se and gives to older males undergoing CABG a more catabolic profile. These modifications could play a role in the short-term outcomes of male patients after CABG.
Significant decrease of anabolic hormones in old male patients undergoing coronary artery bypass graft
BEGHI, CESARE;
2004-01-01
Abstract
During aging there is a decrease of anabolic hormones. Furthermore surgical procedures like CABG (coronary artery bypass graft) induce hormonal changes with an imbalance between anabolic and catabolic spurts. The aim of the study was to investigate the modifications of some hormones in old patients undergoing CABG. We studied 19 patients (12 males , 7 females) aged 70+-6 years (mean +-SD), with a mean BMI of 26,4+-3,8, affected by ischemic cardiomyopathy (NYHA class of 3.5) with an EF <40%.The mean score of comorbidity class(according Greenfield)was 2,55. CABG mean duration was 4.5 hours. Blood samples were collected: 1 day before, the day of the operation, after the anaesthetic induction, at 1,2,3,4 days ,1 and 3 months after. Total testosterone, SHBG, GH, IGF-1, cortisol, DHEA and DHEAS were measured with IRMA. Immediately after surgery and for the first week, there was a significant decrease of IGF-1. Similar results were observed for SHBG. Testosterone levels showed a gender-related pattern of secretion; in males there was a significant decrease lasting for the first week while in females there was a consistent increase. Cortisol, DHEA and DHEAS followed a similar pattern induced by the surgical stress with an unmodified cortisol/DHEA-DHEAS molar ratio. GH was slightly increased for the first 2-3 days. This hormonal pattern worsens the metabolic imbalance due to aging per se and gives to older males undergoing CABG a more catabolic profile. These modifications could play a role in the short-term outcomes of male patients after CABG.
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