title: Endogenous oestradiol but not testosterone is related to coronary artery disease in men.
abstract: OBJECTIVE
  Men die of coronary artery disease (CAD) more often than women. There is evidence that testosterone either is neutral or has a beneficial effect on male cardiovascular disease. The role of oestrogens in male CAD has been less studied. This study was carried out with the purpose of evaluating the relationship between sex hormone levels and CAD.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Men (aged 40-70) submitted to coronary angiography. A 70% occlusion of at least one major coronary artery defined the cases; subjects with ≤ 50% occlusion constituted the control group.
  
  
  METHODS
  Blood samples were collected for total testosterone (TT), oestradiol, luteinizing hormone, follicle-stimulating hormone, sex hormone-binding globulin, lipid profile and albumin measurements. Bioavailable and free testosterone, free androgen index (FAI) and free oestrogen index (FEI) were calculated. Oestradiol and TT levels were examined as terciles, based on the whole study population.
  
  
  RESULTS
  Of the 140 patients included, 72 were cases and 68 were controls. The baseline characteristics of the two groups were similar, except for the older age and lower LDL-C in the cases. Oestradiol and FEI but not total, bioavailable and free testosterone and FAI correlated positively with CAD. After adjustments for potential confounders, oestradiol remained statistically significant. The prevalence of CAD was significantly higher in the 3rd than in the 1st tercile of oestradiol.
  
  
  CONCLUSIONS
  In this study, men with CAD had higher oestradiol and FEI levels. Additional studies are needed to clarify the direction of causality and possible underlying mechanisms.
authors.affiliation: Division of Endocrinology, Department of Medicine, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
authors.forename: Emmanuela Quental
authors.initials: EQ
authors.lastname: Callou de Sá
authors.forename: Francisco Carleial
authors.initials: FC
authors.lastname: Feijó de Sá
authors.forename: Rebeca de Souza
authors.initials: Rde S
authors.lastname: e Silva
authors.forename: Kelly Cristina
authors.initials: KC
authors.lastname: de Oliveira
authors.forename: Alexis Dourado
authors.initials: AD
authors.lastname: Guedes
authors.forename: Fausto
authors.initials: F
authors.lastname: Feres
authors.forename: Ieda Therezinha do Nascimento
authors.initials: IT
authors.lastname: Verreschi
mesh_terms: D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000097:blood; D016022:Case-Control Studies; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood* / Q000453:epidemiology; D004958:Estradiol / Q000097:blood*; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013739:Testosterone / Q000097:blood*
chemical_list: D012739:Gonadal Steroid Hormones; D013739:Testosterone; D004958:Estradiol