Endogenous Sex Hormones and Progression of Carotid Atherosclerosis in Elderly Men

Muller, Majon; Beld, Annewieke W. van den; Bots, Michiel L.; Grobbee, Diederick E.; Lamberts, Steven W. J.; Schouw, Yvonne T. van der

doi:10.1161/01.cir.0000125854.51637.06

Cited by 284 publications

(195 citation statements)

References 46 publications

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“…Carotid artery intima-media thickness, a common marker of clinical and subclinical atherosclerosis, has been shown to be correlated inversely with testosterone levels. [65][66][67] Demirbag et al 68 reported a similar finding by examining the intima thickness of the thoracic aorta in older men. Similarly, in the Rotterdam Study population, Hak et al 69 demonstrated that both bioavailable and total testosterone levels were negatively associated with calcified deposits in the abdominal aorta in men older than 55 years of age.…”

Section: Association Of Low Testosterone With Surrogate Markers Of Atmentioning

confidence: 65%

Hormonal effects on blood vessels

Akishita

2012

Hypertens Res

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The incidence of cardiovascular disease (CVD) is lower in younger women than in men of the same age, but it increases after menopause, implicating the atheroprotective action of endogenous estrogen. Although observational studies have suggested the efficacy of estrogen therapy in postmenopausal women, placebo-controlled, randomized trials, such as the Women's Health Initiative, have not confirmed effects of estrogen therapy on CVD. Conversely, basic, experimental research has progressed and provided mechanistic insight into estrogen's action on blood vessels. By contrast, the vascular effects of androgens remain poorly understood and have been controversial for a long time. In recent years, an increasing body of evidence has suggested that androgens may exert protective effects against the development of atherosclerosis, at least in elderly men. Epidemiological studies have shown that the incidence of and mortality due to CVD were increased in elderly men with low testosterone levels, although the efficacy of androgen therapy remains unknown. Furthermore, recent experimental studies have demonstrated the direct action of androgens on the vasculature. In this review, we illustrate the effects of sex steroids on the cardiovascular system, focusing on the action of testosterone on the blood vessels.

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Section: Association Of Low Testosterone With Surrogate Markers Of Atmentioning

confidence: 65%

Hormonal effects on blood vessels

Akishita

2012

Hypertens Res

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“…Moreover, hypogonadism is associated with increased insulin resistance and progression of atherosclerosis [2,29]. Because men with type 2 diabetes have relative hypogonadism, supplementation with androgen might reduce both insulin resistance and atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Low Serum Testosterone Concentration in Middle-aged Men with Type 2 Diabetes

et al. 2007

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Abstract. Low concentrations of endogenous androgens have been linked with insulin resistance and atherosclerosis. Men with diabetes have been reported to have lower serum testosterone concentration than non-diabetic men; however, there has never been a large study. The aim of this study was to investigate if endogenous androgen concentration is certainly lower in a relatively large number of Japanese patients with type 2 diabetes compared with healthy men, and to identify what factors may be associated with low serum testosterone concentrations in men with type 2 diabetes. Serum free testosterone concentrations were measured in 524 healthy men and in 331 consecutive Japanese men with type 2 diabetes between 40 and 69 years old. In addition, we investigated the relationships between serum free testosterone concentration and luteinizing hormone (LH) concentration as well as major cardiovascular risk factors including age, blood pressure, plasma lipid concentration, glycemic control (HbA 1c ), and BMI. Serum free testosterone concentrations were lower in men with type 2 diabetes than in healthy men in the 40-49 years group (10.9 ± 3.3 vs. 14.0 ± 3.6 pg/ml, P<0.0001), in the 50-59 years group (10.4 ± 3.2 vs. 12.1 ± 2.9 pg/ml, P<0.0001), and in the 60-69 years group (9.5 ± 2.6 vs. 10.5 ± 2.9 pg/ml, P = 0.0104). A negative correlation was found between serum free testosterone and LH concentrations (r = -0.326, P<0.0001). In conclusion, serum free testosterone concentration is certainly lower in a relatively large number of Japanese patients with type 2 diabetes compared with healthy men with each decade of life between 40 and 69 years old.

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“…Data on reproducibility on the intima-media thickness measurements come from several studies that we performed at the Julius Centre, using the same training, certification and reading procedures as the present study with the same readers. These studies showed an intraclass correlation coefficient ranging from 0.84 to 0.92 for repeated common CIMT measurement in single-and multicentre studies [22][23][24].…”

Section: Assessment Of Carotid Atherosclerosismentioning

confidence: 96%

High cumulative insulin exposure: a risk factor of atherosclerosis in type 1 diabetes?

et al. 2005

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Background: Since insulin therapy might have an atherogenic effect, we studied the relationship between cumulative insulin dose and atherosclerosis in type 1 diabetes. We have focused on patients with type 1 diabetes instead of type 2 diabetes to minimise the effect of insulin resistance as a potential confounder. Methods: An observational study was performed in 215 subjects with type 1 diabetes treated with multiple insulin injection therapy. Atherosclerosis was assessed by measurement of carotid intima-media thickness (CIMT). Results: The cumulative dose of regular insulin showed a positive and significant relation with CIMT: increase of 21 m in CIMT per S.D. of insulin use (95% CI: 8-35 adjusted for gender and age), which remained unchanged after adjustment for duration of diabetes, HbA1c, BMI, pulse pressure, physical activity and carotid lumen diameter. A similar relation was found for intermediate-acting insulin: 15.5 m per S.D. (2-29), which was no longer present after further adjustment. Conclusions: These findings provide evidence that a high cumulative dose of regular insulin is a risk factor for atherosclerosis.

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Endogenous Sex Hormones and Progression of Carotid Atherosclerosis in Elderly Men

Cited by 284 publications

References 46 publications

Hormonal effects on blood vessels

Hormonal effects on blood vessels

Low Serum Testosterone Concentration in Middle-aged Men with Type 2 Diabetes

High cumulative insulin exposure: a risk factor of atherosclerosis in type 1 diabetes?

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