Testosterone to oestradiol ratio reflects systemic and plaque inflammation and predicts future cardiovascular events in men with severe atherosclerosis

Koeverden, Ian D. van; Bakker, Michael den; Haitjema, Saskia; Laan, Sander W. van der; Vries, J.P.P.M. de; Hoefer, Imo E.; Borst, Gert J. de; Pasterkamp, Gérard; Ruijter, Hester M. den

doi:10.1093/cvr/cvy188

Cited by 60 publications

(49 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although an increase in estradiol without a concurrent analysis of testosterone does not necessarily suggest either a beneficial or a harmful outcome, in this study, testosterone level did not predict any of the parameters, such as body metabolism or composition, without the simultaneous analysis of estradiol. These findings are consistent with studies suggesting a simultaneous increase in testosterone and estradiol has synergistic positive effects, which include metabolic parameters (29)(30)(31)(32)(33). Conversely, fat mass reduced testosterone levels, which can be justified by exposure of testosterone to a more intense aromatase enzyme under higher body fat (31,32).…”

Section: Biochemical Responses As Predictors Of Other Biochemical Andsupporting

confidence: 90%

“…This ratio indicates whether an increase in estradiol is followed by an increase in testosterone; it should remain unaffected in the case of a physiological increase. These data were supported by a recent study showing that increased estradiol benefitted males in terms of increasing their libido, muscle mass, and bone mass, and reducing their fat mass, but only when accompanied by increased testosterone levels (26)(27)(28), which occurs when increased estradiol is actually desirable and the T:E ratio is unaffected (29). Conversely, the estradiol increase that we identified as a marker of OTS was due to a pathological conversion from testosterone, indicated by a substantial decrease in the T:E ratio, which was most likely a response to an anti-anabolic environment.…”

Section: Testosterone Estradiol and Testosterone-to-estradiol (T:e)supporting

confidence: 60%

“…Hence, the balance between testosterone and estradiol might be more important than either testosterone or estradiol alone. This is extensively supported by the literature, since the T:E ratio predicts multiple outcomes, including cardiovascular changes (29,30), while many of the neuroprotective and psychological effects of estradiol in males are mediated by testosterone (32)(33)(34), which requires a balance between these hormones to obtain the health benefits. The unaltered balance is more precisely assessed by the T:E ratio, rather than each hormone alone.…”

Section: Testosterone Estradiol and Testosterone-to-estradiol (T:e)mentioning

confidence: 80%

“…Although estradiol alone did not predict body metabolism or composition parameters, it independently predicted lower anger. Although estradiol receptors are widely distributed in the brain (29,33,34), their effects on mood in males are still unclear. Body water content was the only predictor of fat oxidation, which supports the premise that good hydration status, particularly within the cells, is a key requirement for proper fat oxidation, as water is part of this pathway (35)(36)(37), while dehydration slightly impaired fat burning.…”

Section: Biochemical Responses As Predictors Of Other Biochemical Andmentioning

confidence: 99%

See 3 more Smart Citations

Inter-correlations Among Clinical, Metabolic, and Biochemical Parameters and Their Predictive Value in Healthy and Overtrained Male Athletes: The EROS-CORRELATIONS Study

Cadegiani

Kater

2019

Front. Endocrinol.

View full text Add to dashboard Cite

Objectives: The Endocrine and Metabolic Responses on Overtraining Syndrome (EROS) study identified multiple hormonal and metabolic conditioning processes in athletes, and underlying mechanisms and biomarkers of overtraining syndrome (OTS). The present study's objective was to reveal independent predictors and linear correlations among the parameters evaluated in the EROS study to predict clinical, metabolic, and biochemical behaviors in healthy and OTS-affected male athletes. Methods: We used multivariate linear regression and linear correlation to analyze possible combinations of the 38 parameters evaluated in the EROS study that revealed significant differences between healthy and OTS-affected athletes. Results: The testosterone-to-estradiol (T:E) ratio predicted the measured-to-predicted basal metabolic rate (BMR) ratio; the T:E ratio and total testosterone level were inversely predicted by fat mass and estradiol was not predicted by any of the non-modifiable parameters. Early and late growth hormone, cortisol, and prolactin responses to an insulin tolerance test (ITT) were strongly correlated. Hormonal responses to the ITT were positively correlated with fat oxidation, predicted-to-measured BMR ratio, muscle mass, and vigor, and inversely correlated with fat mass and fatigue. Salivary cortisol 30 min after awakening and the T:E ratio were inversely correlated with fatigue. Tension was inversely correlated with libido and directly correlated with body fat. The predicted-to-measured BMR ratio was correlated with muscle mass and body water, while fat oxidation was directly correlated with muscle mass and inversely correlated with fat mass. Muscle mass was directly correlated with body water, and extracellular water was directly correlated with body fat and inversely correlated with body water and muscle mass. Conclusions: Hypothalamic-pituitary responses to stimulation were diffuse and indistinguishable between the different axes. A late hormonal response to stimulation, increased cortisol after awakening, and the T:E ratio were correlated with vigor and Cadegiani and Kater The EROS-CORRELATIONS Study fatigue. The T:E ratio was also correlated with body metabolism and composition, testosterone was predicted by fat mass, and estradiol predicted anger. Hydration status was inversely correlated with edema, and inter-correlations were found among fat oxidation, hydration, and body fat.

show abstract

Section: Biochemical Responses As Predictors Of Other Biochemical Andsupporting

confidence: 90%

Section: Testosterone Estradiol and Testosterone-to-estradiol (T:e)supporting

confidence: 60%

Section: Testosterone Estradiol and Testosterone-to-estradiol (T:e)mentioning

confidence: 80%

Section: Biochemical Responses As Predictors Of Other Biochemical Andmentioning

confidence: 99%

See 2 more Smart Citations

Inter-correlations Among Clinical, Metabolic, and Biochemical Parameters and Their Predictive Value in Healthy and Overtrained Male Athletes: The EROS-CORRELATIONS Study

Cadegiani

Kater

2019

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…72,73 These aspects should also be considered in the light of sexual dimorphism related to susceptibility to CV inflammation. [74][75][76] High serum IL-6 levels are a common feature in CRS patients. Indeed, in a recent retrospective multicentre analysis of 150 patients from Wuhan, circulating IL-6 levels were a clinical predictor of mortality in COVID- 19.…”

Section: Covid-19 Inflammation and The Cytokine Release Stormmentioning

confidence: 99%

COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options

Guzik

Mohiddin

Dimarco³

et al. 2020

Cardiovascular Research

1,284

1,347

View full text Add to dashboard Cite

The novel coronavirus disease (COVID-19) outbreak, caused by SARS-CoV-2, represents the greatest medical challenge in decades. We provide a comprehensive review of the clinical course of COVID-19, its comorbidities, and mechanistic considerations for future therapies. While COVID-19 primarily affects the lungs, causing interstitial pneumonitis and severe acute respiratory distress syndrome (ARDS), it also affects multiple organs, particularly the cardiovascular system. Risk of severe infection and mortality increase with advancing age and male sex. Mortality is increased by comorbidities: cardiovascular disease, hypertension, diabetes, chronic pulmonary disease, and cancer. The most common complications include arrhythmia (atrial fibrillation, ventricular tachyarrhythmia, and ventricular fibrillation), cardiac injury [elevated highly sensitive troponin I (hs-cTnI) and creatine kinase (CK) levels], fulminant myocarditis, heart failure, pulmonary embolism, and disseminated intravascular coagulation (DIC). Mechanistically, SARS-CoV-2, following proteolytic cleavage of its S protein by a serine protease, binds to the transmembrane angiotensin-converting enzyme 2 (ACE2) —a homologue of ACE—to enter type 2 pneumocytes, macrophages, perivascular pericytes, and cardiomyocytes. This may lead to myocardial dysfunction and damage, endothelial dysfunction, microvascular dysfunction, plaque instability, and myocardial infarction (MI). While ACE2 is essential for viral invasion, there is no evidence that ACE inhibitors or angiotensin receptor blockers (ARBs) worsen prognosis. Hence, patients should not discontinue their use. Moreover, renin–angiotensin–aldosterone system (RAAS) inhibitors might be beneficial in COVID-19. Initial immune and inflammatory responses induce a severe cytokine storm [interleukin (IL)-6, IL-7, IL-22, IL-17, etc.] during the rapid progression phase of COVID-19. Early evaluation and continued monitoring of cardiac damage (cTnI and NT-proBNP) and coagulation (D-dimer) after hospitalization may identify patients with cardiac injury and predict COVID-19 complications. Preventive measures (social distancing and social isolation) also increase cardiovascular risk. Cardiovascular considerations of therapies currently used, including remdesivir, chloroquine, hydroxychloroquine, tocilizumab, ribavirin, interferons, and lopinavir/ritonavir, as well as experimental therapies, such as human recombinant ACE2 (rhACE2), are discussed.

show abstract

Prediagnostic circulating levels of sex hormones and survival in esophageal adenocarcinoma

Xie

Ness-Jensen

Langseth

et al. 2020

Intl Journal of Cancer

View full text Add to dashboard Cite

Sex hormonal differences may contribute to the strong male predominance in esophageal adenocarcinoma (EAC), but whether sex hormone levels influence survival in EAC is unstudied. Our study aimed to assess associations between prediagnostic sex hormone levels and survival in EAC. In a population-based cohort study, 244 male EAC patients from the Janus Serum Bank Cohort in Norway were followed up through 2018. Associations between prediagnostic serum levels of 12 sex hormone measures and disease-specific mortality were assessed using multivariable Cox regression, providing hazard ratios (HR) with 95% confidence intervals (CI) adjusted for age, calendar year, body mass index, tobacco smoking, physical activity and surgical resection. Higher levels of sex hormone-binding globulin (SHBG) indicated decreased disease-specific mortality (HR 0.68, 95% CI 0.44-1.07, highest vs lowest tertile). In stratified analyses by surgery, such associations remained in nonoperated patients (HR 0.58, 95% CI 0.35-0.96, highest vs lowest tertile), but not in operated patients. Higher levels of follicle-stimulating hormone (FSH) were associated with increased disease-specific mortality in an exposure-response pattern; HRs for the middle and highest tertiles vs the lowest tertile were 1.35 (95% CI 0.89-2.05) and 1.61 (95% CI 1.06-2.43), respectively. No clear associations were observed with serum levels of dehydroepiandrosterone sulfate, luteinizing hormone, prolactin, testosterone, 17-OH-progesterone, progesterone, estradiol, androstenedione, testosterone:estradiol ratio or free testosterone index. These findings suggest that higher endogenous levels of SHBG and lower levels of FSH may increase the survival in EAC. The other 10 examined sex hormone measures may not influence the survival.

show abstract

Testosterone to oestradiol ratio reflects systemic and plaque inflammation and predicts future cardiovascular events in men with severe atherosclerosis

Cited by 60 publications

References 34 publications

Inter-correlations Among Clinical, Metabolic, and Biochemical Parameters and Their Predictive Value in Healthy and Overtrained Male Athletes: The EROS-CORRELATIONS Study

Inter-correlations Among Clinical, Metabolic, and Biochemical Parameters and Their Predictive Value in Healthy and Overtrained Male Athletes: The EROS-CORRELATIONS Study

COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options

Prediagnostic circulating levels of sex hormones and survival in esophageal adenocarcinoma

Contact Info

Product

Resources

About