Association of Troponins With Sex Hormones in Stable Hemodialysis Patients

Background Cardiovascular events are one of the major causes of death in dialysis. Usually, troponins are regarded gold standard for detecting cardiovascular complications. In addition, studies have confirmed a difference between men and women regarding cardiovascular and renal diseases. Objectives To investigate the relation between troponins (Hs-TnT) and biomarkers, including sex hormone binding globulin (SHBG), estradiol, total and free testosterone, ferritin, Albumin, CRP and estimated glomerular filtration rate (eGFR) in hemodialysis. Patients and MethodsSixty-one hemodialysis patients were enrolled in this study. Hs-cTnT, cTnI, total testosterone, free testosterone, SHBG, estradiol, Albumin, CRP, ferritin, urea and creatinine were estimated. ResultsHs-cTnT was associated with Albumin (R=-0.3; P=0.01). Troponin showed no association with the rest of the markers. The mean values in the dialysis group were: Hs-cTnT 93.8 pg/ml; ferritin 222.1 µg/l; albumin 4.18 g/dl; CRP 18.4 mg/l; urea 143.3 mg/dl; creatinine 9.4 mg/dl; total testosterone 1.46 ng/ml; free testosterone 28.75 pg/ml when compared to the control group, the differences between serum values in dialysis group were significant P < 0.05. The rest of the biomarkers showed no significant differences. ConclusionThe most interesting finding was a negative association of Albumin with Hs-cTnT, indicating the possible use of albumin-adjusted Hs-cTnT rather than troponin alone to better predict critical cardiac events in hemodialysis. Troponin did not associate with SHBG, estradiol and testosterone hormones, possibly indicating no obvious role of these hormones in troponin regulation. Estimated GFR levels showed no correlation, suggesting troponin might be further degraded before renal elimination.