title: Endogenous sex hormone levels in postmenopausal women undergoing carotid artery endarterectomy.
abstract: 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.
authors.affiliation: Department of Vascular Surgery, Academic Hospital, Free University of Brussels, Belgium. erik.debing@az.vub.ac.be
authors.forename: Erik
authors.initials: E
authors.lastname: Debing
authors.forename: Els
authors.initials: E
authors.lastname: Peeters
authors.forename: William
authors.initials: W
authors.lastname: Duquet
authors.forename: Kris
authors.initials: K
authors.lastname: Poppe
authors.forename: Brigitte
authors.initials: B
authors.lastname: Velkeniers
authors.forename: Pierre
authors.initials: P
authors.lastname: Van den Brande
mesh_terms: 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
chemical_list: 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