Endogenous estrogen levels are associated with endothelial function in males independently of lipid levels
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ORIGINAL ARTICLE
Endogenous estrogen levels are associated with endothelial function in males independently of lipid levels Katerina Saltiki • George Papageorgiou • Paraskevi Voidonikola • Emily Mantzou • Konstantinos Xiromeritis • Christos Papamichael Maria Alevizaki • Kimon Stamatelopoulos
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Received: 23 September 2009 / Accepted: 23 December 2009 / Published online: 16 January 2010 Ó Springer Science+Business Media, LLC 2010
Abstract Estrogens and androgens may play an important role in vascular health in both sexes. The aim of this study was to examine the relation of endogenous sex hormone levels with early markers of atherosclerosis in a cohort of apparently healthy males. 124 males (age 46.25 ± 9.56) attending a preventive medicine program were examined for unrecognised features of the metabolic syndrome. Flowmediated dilatation (FMD) and intima-media thickness (IMT) of the common carotid artery were evaluated. Obesity parameters were recorded; estradiol, testosterone, SHBG, free testosterone, insulin, as well as glucose and lipid levels were measured. FMD was positively correlated with estradiol (r = 0.201, P = 0.041) and negatively with total cholesterol (r = -0.205, P = 0.022), low density lipoproteins (r = -0.232, P = 0.009), and triglyceride levels (r = -0.179, P = 0.046). In multivariate analysis, the association of FMD with estrogen was independent of BMI and lipid levels. No significant association between FMD and testosterone levels was found. Subjects with an increased mean IMT ([0.73 mm, i.e., [3rd tertile) had lower levels of free (P = 0.021) and bioavailable
K. Saltiki E. Mantzou M. Alevizaki Endocrine Unit, Evgenidion Hospital, Athens University School of Medicine, Athens, Greece K. Saltiki (&) G. Papageorgiou M. Alevizaki Endocrine Unit, Department of Clinical Therapeutics, Alexandra Hospital, Athens University School of Medicine, 80, Vass Sofias Ave, 11528 Athens, Greece e-mail: [email protected] P. Voidonikola K. Xiromeritis C. Papamichael K. Stamatelopoulos Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Athens University School of Medicine, Athens, Greece
(P = 0.016) testosterone. In multivariate logistic regression analysis, this association was no longer significant when age or cholesterol levels were considered. Endogenous estrogen levels are associated with FMD, independently of age and lipid levels, showing a protective effect in middle-age male subjects. Circulating androgens are associated, although not independently, with structural changes such as the IMT of carotid artery; this effect is possibly influenced by lipid levels and age. Keywords Flow-mediated dilatation Intima-media thickness Males Estrogen Androgen Cardiovascular
Introduction Several studies have shown that endogenous sex hormones may play an important role in cardiovascular health in both sexes [1–4]. It has been shown that estrogens may modulate several vasoactive, pro-inflammatory, and metabolic factors which influence the vasculature [5]. Moreover, it has be
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