Nonlinear association between serum testosterone levels and coronary artery disease in Iranian men (original) (raw)
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The Effect of Low Testosterone and Estrogen Levels on Progressive Coronary Artery Disease in Men
Reports of biochemistry & molecular biology, 2019
Background Age-related morbidity and mortality rates from coronary heart disease (CHD) are higher in men than in women. Abnormal androgen levels cause a variety of abnormal symptoms in men. Testosterone and estrogen are the main sex hormone in men and women, respectively, and studies have shown that they have important roles in cardiovascular health and disease. Methods We measured testosterone and estrogen in 102 men with coronary heart disease and 45 controls. Blood samples were collected from subjects and plasma testosterone and estrogen were measured by ELISA. Results Men with coronary heart disease had less testosterone (OD Ratio: 0.782) and estrogen (OD Ratio: 0.955) than controls. Conclusion Low testosterone and estrogen levels correlate with coronary artery disease.
American Heart Journal, 2020
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Evaluation of Androgen Levels in Patients with Acute Coronary Syndrome
Medicine Science | International Medical Journal, 2012
The aim of the study was to determine plasma levels of free Testosterone (fT) and dehydroepiandrosterone sulphate (DHEA-S) in male patients with acute coronary syndrome. We measured the serum fT and DHEA-S levels of 30 healthy male subjects and 64 male patients with acute coronary syndrome whose coronary artery diseases were confirmed by coronary angiography. We observed no difference between two groups on the level of fT while DHEA-S level was significantly lower (p = 0.01). No correlation had existed between lipid parameters and levels of fT and DHEA-S. More comprehensive studies are needed to clarify whether lower levels of DHEAS are contributed to acute coronary syndrome or not.
OBJECTIVE: Low testosterone levels in men have been associated with an increased risk of cardiovascular disease. We aimed to identify the association between serum testosterone level and premature coronary artery disease (CAD) and its predictors in young adult males. METHODS: In this cross sectional study, consecutive male candidates for coronary angiography with unstable angina, no previous CAD and age ≤ 45 years were included. Serum levels of free (FT) and total testosterone (TT) as well as demographic and cardiovascular characteristics were compared between the CAD-positive and normal coronary subjects. The cutoff point for low TT was 2.5 ng/L. Additionally, the relationships between all the variables and the number of affected vessels and FT and TT and predictors of CAD were assessed. RESULTS: In this study, 191 patients with premature CAD were compared with 94 normal coronary subjects. Patients in the CAD group were significantly older (41.59 ± 3.79 versus 39.27 ± 4.97 years; P-value < 0.01), and had higher rates of diabetes mellitus (P-value = 0.04) and dyslipidemia (P-value = 0.01). Serum levels of FT and TT were significantly lower in the CAD group than the normal coronary subjects (P-value < 0.01 for both). The rate of subjects with low TT increased by the number of the affected vessels (p-value for trend <0.01) and there was a significant correlation between the Gensini score and FT and TT (r = -0.37, P-value < 0.01 and r = -0.34, P-value < 0.01, respectively). After adjustment for confounders, the association between low TT and CAD remained significant (Odds ratio = 4.30, 95% confidence interval: 1.99-9.32; P-value ≤ 0.001) CONCLUSION: Low levels of testosterone were associated with premature CAD and its severity in young adults.
Free testosterone and cardiometabolic parameters in men: comparison of algorithms
Endocrine Connections
Objective Calculating the free testosterone level has gained increasing interest and different indirect algorithms have been suggested. The objective was to compare free androgen index (FAI), free testosterone estimated using the linear binding model (Vermeulen: cFTV) and the binding framework accounting for allosterically coupled SHBG monomers (Zakharov: cFTZ) in relation to cardiometabolic conditions. Design A prospective cohort study including 5350 men, aged 30–70 years, participating in population-based surveys (MONICA I–III and Inter99) from 1982 to 2001 and followed until December 2012 with baseline and follow-up information on cardiometabolic parameters and vital status. Results Using age-standardized hormone levels, FAI was higher among men with baseline cardiometabolic conditions, whereas cFTV and cFTZ levels were lower compared to men without these conditions as also seen for total testosterone. Men in highest quartiles of cFTV or cFTZ had lower risk of developing type 2 d...
Journal of andrology
Prior studies have reported men with coronary artery disease (CAD) to have elevated plasma levels of estrogens and reduced concentrations of dehydroepiandrosterone (DHEA) or DHEA-sulfate (DHEAS). We investigated whether gonadal steroids or DHEAS are risk factors for CAD in men, using a prospective design, in a well characterized population studied at regular intervals. We studied 46 men (Cardiac group) who developed CAD and 124 men (Control group) who remained free of CAD (mean follow-up, 9.5 years). We measured testosterone (T), estradiol (E2), and DHEAS, as well as plasma binding of T and E2, in samples stored before the onset of CAD (Cardiac group) or at matched times (Control group). Body mass index, blood pressure, and total serum cholesterol were measured at each visit. Both systolic blood pressure (SBP; P less than 0.001) and cholesterol (P less than 0.001) were increased in the Cardiac group, but no significant differences were found in total or free T or E2, the ratio of E2...
Clinical endocrinology, 2015
Whether endogenous sex hormones play a role in cardiovascular disease (CVD) risk in men is unclear. Few studies have examined associations of sex hormones with atherosclerosis measured by coronary artery calcium score (CACS) and carotid intima-media thickness (cIMT).We evaluated the association of testosterone (T) and other sex hormones with CACS and cIMT. Using the large multi-ethnic cohort of 3164 men without known CVD in the Multi-Ethnic Study of Atherosclerosis (MESA), cross-sectional associations of tertiles of endogenous sex hormones with CACS and cIMT were analyzed. In regards to CAC, there was a significant negative trend (P-trend=0.02) for CACS>0 over tertiles of free T (FT) with RRs (95% CI) for the lowest to highest tertiles. There was also a marginally significant positive trend (P-trend=0.06) for CACS>0 over tertiles of sex hormone binding globulin (SHBG) with RRs for the lowest to highest tertiles. There were no significant associations with CACS > 0 for terti...
Role of Androgens in Cardiovascular Diseases in Men: A Comprehensive Review
Chemistry and Biological Activity of Steroids, 2020
The present knowledge on the androgens role in cardiovascular physiology is not fully completed. It remains unclear whether low serum testosterone concentrations in men are an independent risk factor for cardiovascular diseases (CVDs) or a marker of the presence of CVD. However, we demonstrated that endogenous testosterone levels may be implicated in CVDs. Androgens role in modulating cardiovascular function is one of the highest importances, given that its deficiency is strongly associated with hypertension, atherosclerosis, diabetes, obesity, and cardiac hypertrophy. Although significant and independent association between testosterone levels and cardiovascular events in elderly men have not been confirmed in large prospective studies, cross-sectional studies, however, suggested that low testosterone levels in elderly men are associated with CVDs. The results of androgen therapy are not also conclusive. Perhaps, the effects of testosterone treatment of cardiovascular mortality and morbidity have not been extensively examined in control studies. Data on male animal experimentation of the effect of testosterone replacement therapy are either neutral or beneficial on the development of atherosclerosis. Since circulatory androgen levels modulation is expected to cause many other side effects, it seems to be essential to develop a strategy to target androgen receptor for better treating the CVDs.
Low serum testosterone and increased mortality in men with coronary heart disease
Heart, 2010
Background To examine the effect of serum testosterone levels on survival in a consecutive series of men with confirmed coronary disease and calculate the prevalence of testosterone deficiency. Design Longitudinal follow-up study. Setting Tertiary referral cardiothoracic centre. Patients 930 consecutive men with coronary disease referred for diagnostic angiography recruited between June 2000 and June 2002 and followed up for a mean of 6.962.1 years. Outcome All-cause mortality and vascular mortality. Prevalence of testosterone deficiency. Results The overall prevalence of biochemical testosterone deficiency in the coronary disease cohort using bio-available testosterone (bio-T) <2.6 nmol/l was 20.9%, using total testosterone <8.1 nmol/l was 16.9% and using either was 24%. Excess mortality was noted in the androgen-deficient group compared with normal (41 (21%) vs 88 (12%), p¼0.002). The only parameters found to influence time to all-cause and vascular mortality (HR 6 95% CI) in multivariate analyses were the presence of left ventricular dysfunction (3.85; 1.72 to 8.33), aspirin therapy (0.63; 0.38 to 1.0), b-blocker therapy (0.45; 0.31 to 0.67) and low serum bio-T (2.27; 1.45 to 3.6). Conclusions In patients with coronary disease testosterone deficiency is common and impacts significantly negatively on survival. Prospective trials of testosterone replacement are needed to assess the effect of treatment on survival.