Endogenous sex hormone levels in postmenopausal women undergoing carotid artery endarterectomy.
OBJECTIVE
To study the endogenous sex hormone levels in natural postmenopausal women and their association with the presence of internal carotid artery (ICA) atherosclerosis.


METHODS
Case-control study


METHODS
We compared 56 patients with severe ICA atherosclerosis referred for carotid artery endarterectomy (CEA) with 56 age-matched control subjects free of severe atherosclerotic disease. The presence of atherosclerosis was determined by high-resolution B-mode ultrasound. Metabolic parameters and sex hormones were measured or calculated: total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, insulin, quantitative insulin sensitivity check index, insulin resistance index, IGF-I, DHEA, DHEA sulfate (DHEA-S), free testosterone, total testosterone, estrone, estradiol, androstenedione, and sex hormone-binding globulin.


RESULTS
The cases had statistically significant lower levels of both total testosterone (0.23 +/- 0.12 vs 0.31 +/- 0.20 microg/l, P = 0.043) and free testosterone (3.42 +/- 1.94 vs 4.59 +/- 2.97 ng/l, P = 0.009) and significantly lower levels of androstenedione (625.3 +/- 168.7 vs 697.0 +/- 211.9 ng/l, P = 0.017) when compared with controls. Multivariate linear regression analysis, adjusted for traditional cardiovascular risk factors, baseline and physiologic characteristics, showed a significant inverse relationship between both serum free testosterone (beta = -0.234, P = 0.028) and androstenedione (beta = -0.241, P = 0.028) levels with the presence of severe atherosclerosis of ICA.


CONCLUSIONS
The study provides evidence of a positive association between low serum androgen levels and severe ICA atherosclerosis in postmenopausal women. It suggests that higher, but physiological, levels of androgens in postmenopausal women have a protective role in the development of atherosclerosis of ICA.
Debing
Erik
E
Department of Vascular Surgery, Academic Hospital, Free University of Brussels, Belgium. erik.debing@az.vub.ac.be
Peeters
Els
E
Duquet
William
W
Poppe
Kris
K
Velkeniers
Brigitte
B
Van den Brande
Pierre
P
D000368:Aged; D000735:Androstenedione / Q000097:blood; D001786:Blood Glucose; D002340:Carotid Artery Diseases / Q000378:metabolism* / Q000601:surgery*; D003687:Dehydroepiandrosterone / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D016894:Endarterectomy, Carotid; D004958:Estradiol / Q000097:blood; D004970:Estrone / Q000097:blood; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008875:Middle Aged; D017698:Postmenopause / Q000378:metabolism*; D012720:Severity of Illness Index; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D012739:Gonadal Steroid Hormones; D007328:Insulin; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D012738:Sex Hormone-Binding Globulin; D014280:Triglycerides; D004970:Estrone; D013739:Testosterone; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D004958:Estradiol; D019314:Dehydroepiandrosterone Sulfate