Increased carotid atherosclerosis in andropausal middle-aged men.
OBJECTIVE
This study examined the association between carotid artery intima-media thickness (IMT), serum sex hormone levels, and andropausal symptoms in middle-aged men.


BACKGROUND
Male sex hormones may play a dual role in the pathogenesis of atherosclerosis in men by carrying both proatherogenic and atheroprotective effects.


METHODS
We studied 239 40- to 70-year-old men (mean +/- SD: 57 +/- 8 years) who participated in the Turku Aging Male Study and underwent serum lipid and sex hormone measurements. Ninety-nine men (age 58 +/- 7 years) were considered andropausal (i.e., serum testosterone <9.8 nmol/l or luteinizing hormone [LH] >6.0 U/l and testosterone in the normal range), and in both situations, they had subjective symptoms of andropause (a high symptom score in questionnaire). Three were excluded because of diabetes. The rest of the men (age 57 +/- 8 years) served as controls. Carotid IMT was determined using high-resolution B-mode ultrasound, and serum testosterone, estradiol (E2), LH, and sex hormone-binding globulin were measured using standard immunoassays.


RESULTS
Andropausal men had a higher maximal IMT compared with controls in the common carotid (1.08 +/- 0.34 vs. 1.00 +/- 0.23, p < 0.05) and in the carotid bulb (1.44 +/- 0.48 vs. 1.27 +/- 0.35, p = 0.003). Common carotid IMT correlated inversely with serum testosterone (p = 0.003) and directly with LH (p = 0.006) in multivariate models adjusted for age, total cholesterol, body mass index, blood pressure, and smoking.


CONCLUSIONS
Middle-aged men with symptoms of andropause, together with absolute or compensated (as reflected by high normal to elevated LH) testosterone deficiency, show increased carotid IMT. These data suggest that normal testosterone levels may offer protection against the development of atherosclerosis in middle-aged men.
Mäkinen
Juuso
J
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.
Järvisalo
Mikko J
MJ
Pöllänen
Pasi
P
Perheentupa
Antti
A
Irjala
Kerttu
K
Koskenvuo
Markku
M
Mäkinen
Juha
J
Huhtaniemi
Ilpo
I
Raitakari
Olli T
OT
D000328:Adult; D000367:Age Factors; D000368:Aged; D047649:Andropause / Q000502:physiology*; D016893:Carotid Stenosis / Q000097:blood / Q000175:diagnosis*; D004453:Echoencephalography; D005387:Finland; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013739:Testosterone / Q000172:deficiency; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging
D012739:Gonadal Steroid Hormones; D008055:Lipids; D013739:Testosterone