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Elevated Plasma Concentration of Asymmetric Dimethylarginine That Is Reduced by Single Dose Testosterone Administration in Idiopathic Hypogonadotropic Hypogonadism Patients

Departments of Emergency Medicine (E.C., O.O., C.B.), Biochemistry (H.Y., E.O.A., M.K.E.), and Gastroenterology (Z.Y.), Gulhane Military Medical School, Ankara, Turkey

Address all correspondence and requests for reprints to: Dr. Erdinc Cakir, Department of Emergency Medicine, Gulhane Military Medical School, 06010, Etlik, Ankara, Turkey. E-mail: erdcakir{at}yahoo.com.

Our aim was to investigate whether plasma L-arginine and asymmetric dimethylarginine (ADMA) concentrations and nitric oxide (NO) production are altered in male idiopathic hypogonadotropic hypogonadism (IHH) patients in the hypogonadal state and after single dose testosterone administration compared with those in control subjects. Eighteen newly diagnosed male patients with IHH and 20 healthy volunteer controls matched by age and body mass index were enrolled in the study. Single dose testosterone was administrated im. Initially, pretreatment blood samples were collected after overnight fasting. Posttreatment blood samples were drawn 10 d after the injection. ADMA, L-arginine, and NO were measured in pre- and posttreatment blood samples. The pretreatment ADMA and L-arginine levels were significantly higher, and plasma nitrite plus nitrate (NOx) levels were lower than those in the control group. After 10 d of treatment, ADMA and L-arginine levels were significantly reduced, and NOx levels were significantly increased. There was a significant positive correlation (P < 0.01) between ADMA and L-arginine and a negative correlation between ADMA and NOx levels in patients and controls. In conclusion, the patients with IHH showed elevated plasma ADMA levels associated with a reduction in NO production. Single dose parenteral T administration lowered ADMA concentrations and increased NO production to the control group values.