title: Relations between endogenous androgens and estrogens in postmenopausal women with suspected ischemic heart disease.
abstract: BACKGROUND
  Because androgens are obligatory precursors of estrogens, it is reasonable to assume that their serum concentrations would exhibit positive correlations. If so, then epidemiologic studies that examine the association between androgens and pathological processes should adjust the results for the independent effect of estrogens.
  
  
  OBJECTIVE
  The objective of the study was to examine the interrelationships among testosterone (T), androstenedione, estradiol (E2), estrone, and SHBG in postmenopausal women.
  
  
  METHODS
  This was a cross-sectional study of women participating in the National Heart, Blood, and Lung Institute-sponsored Women's Ischemia Syndrome Evaluation study.
  
  
  METHODS
  The study was conducted at four academic medical centers.
  
  
  METHODS
  A total of 284 postmenopausal women with chest pain symptoms or suspected myocardial ischemia.
  
  
  METHODS
  Post hoc analysis of the relationships among sex steroid hormones with insulin resistance, body mass index (BMI), and presence or absence of coronary artery disease as determined by coronary angiography.
  
  
  RESULTS
  BMI was significantly associated with insulin resistance, total E2, free E2, bioavailable E2, and free T. Highly significant correlations were found for total T, free T, and androstenedione with total E2, free E2, bioavailable E2, and estrone and persisted after adjustment for BMI and insulin resistance. A significant relationship was present between total and free T and the presence of coronary artery disease after adjustment for the effect of E2.
  
  
  CONCLUSIONS
  Serum levels of androgens and estrogens track closely in postmenopausal women referred for coronary angiography for suspected myocardial ischemia. Epidemiological studies that relate sex steroid hormones to physiological or pathological processes need to control for the independent effect of both estrogens and androgens.
authors: Department of Medicine, Room 2119, Plaza Level, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California 90048, USA. braunstein@cshs.org
authors: Glenn D
authors: GD
authors: Braunstein
authors: B Delia
authors: BD
authors: Johnson
authors: Frank Z
authors: FZ
authors: Stanczyk
authors: Vera
authors: V
authors: Bittner
authors: Sarah L
authors: SL
authors: Berga
authors: Leslee
authors: L
authors: Shaw
authors: T Keta
authors: TK
authors: Hodgson
authors: Maura
authors: M
authors: Paul-Labrador
authors: Ricardo
authors: R
authors: Azziz
authors: C Noel Bairey
authors: CN
authors: Merz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000728:Androgens / Q000097:blood*; D000735:Androstenedione / Q000097:blood; D015992:Body Mass Index; D002637:Chest Pain / Q000209:etiology; D017023:Coronary Angiography; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood; D004967:Estrogens / Q000097:blood*; D004970:Estrone / Q000097:blood; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000175:diagnosis*; D017698:Postmenopause; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood
chemical_list: D000728:Androgens; D004967:Estrogens; D012738:Sex Hormone-Binding Globulin; D004970:Estrone; D013739:Testosterone; D000735:Androstenedione; D004958:Estradiol