Summary
Objectives: Men die of coronary artery disease more often (CAD) than women. There is evidence that testosterone is either neutral or has a beneficial effect on male cardiovascular disease. The role of oestrogens in male CAD has been less studied. This study was carried out with the purpose of evaluating the relationship between sex hormones levels and coronary artery disease.
Designer: Case-control study.
Participants: Men (aged 40-70) submitted to coronary angiography. A 70% occlusion of at least one major coronary artery defined the cases; subjects with ≤ 50% occlusion constituted the control group.
Measurements: Blood samples were collected for total testosterone, oestradiol, LH, FSH, SHBG, lipid profile and albumin measurements. Bioavailable and free testosterone, FAI and FEI were calculated. Oestradiol and total testosterone levels were examined as terciles, based on the whole study population.
Results: Of the 140 patients included, 72 were cases and 68 were controls. The baseline characteristics of the two groups were similar, except for the older age and lower LDL-C in the cases. Oestradiol and free estrogen index (FEI )but not total, bioavailable and free testosterone and free androgen index (FAI ) correlated positively with CAD. After adjustments for potential confounders oestradiol remained statistically significant. The prevalence of CAD was significantly higher in the 3rd than in the 1st tercile of oestradiol.
Conclusion: In this study, men with CAD had higher oestradiol and FEI levels. Additional studies are needed to clarify the direction of causality and possible underlying mechanisms.
Source:
Artery Disease in Men- Sex hormones and coronary artery disease
DOI: 10.1111/j.1365-2265.2011.04017.x
Copyright © 2011 Blackwell Publishing Ltd
