Sex hormones in men with abdominal aortic aneurysm

Abstract

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Low Progesterone and Low Estradiol Levels Associate With Abdominal Aortic Aneurysms in Men

“…When plasma DHEA, androstenedione, testosterone, and SHBG (all by immunoassay) were addressed in 37 male AAA cases and 91 healthy controls, SHBG but not sex steroids were found to be lower in cases ( 23 ). Contrasting with our findings, Villard et al recently reported a higher frequency of detectable levels of estradiol and progesterone in men with AAA, and lower testosterone in univariate models ( 24 ). While the setting of this study was a similarly sized case-control study of Swedish 65-year-old men recruited at AAA screening, Villard et al used immunoassays with low sensitivity, where 45% and 49% of the control men had estradiol and progesterone levels below the working range of the assay.…”

“…Indeed, a major finding in the present study was that the impact of low estradiol and low progesterone on AAA prediction was additive. Serum estradiol has previously been reported to associate positively with atherosclerosis and cardiovascular outcomes in men, but similar to Villard et al ( 24 ), most of these studies have used immune-based techniques with questionable specificity in the lower range ( 27 ). By contrast, low levels of estradiol assessed by mass spectrometry predict mortality in elderly men ( 33 ).…”

“…In our study, all men had levels of these sex steroids above LLOQ of the LC-MS/MS assay. As discussed above, immunoassays also have lower specificity and may show yet unexplained associations with inflammation markers ( 27 ), which potentially may explain the higher frequency of detectable levels in AAA subjects in the study by Villard et al ( 24 ). These discrepancies further illustrate the importance of using a high-performance sex steroid assay in clinical research ( 30 ).…”

“…Only 3 studies have evaluated the associations between serum sex hormone levels and AAA in men; a population-based cohort study and a small case-control study have reported lower free testosterone levels in men with increasing aortic diameter and/or AAA, but no independent association with total testosterone levels ( 22 , 23 ). Further, a recent study, in which sex hormones were measured by immunoassays, reported higher levels of estradiol and progesterone in men with AAA ( 24 ).…”

A Novel Hypothesis: A Role for Follicle Stimulating Hormone in Abdominal Aortic Aneurysm Development in Postmenopausal Women

“…As the condition primarily affects men, testosterone has been thought to attribute to AAA as demonstrated in murine studies with male mice ( 68 , 69 ), and even in female mice administered testosterone as neonates ( 61 ). However, a recent case-control study comparing 65-year old men with and without AAA found that higher oestrogen, higher progesterone and lower testosterone levels were associated with AAA ( 170 ). The association of low testosterone levels with AAA is in line with an earlier clinical and murine study ( 70 , 77 ).…”