title: Circulating androgen levels are associated with subclinical atherosclerosis and arterial stiffness in healthy recently menopausal women.
abstract: Although increasing evidence supports an association between endogenous sex hormones and cardiovascular disease, the results still remain controversial. This study aims to examine the association between endogenous sex hormones and indices of vascular function and structure. Serum follicle-stimulating hormone, luteinizing hormone, estradiol, testosterone, sex hormone-binding globulin, dehydroepiandrosterone sulfate (DHEAS), and Δ4-androstenedione were measured in 120 healthy postmenopausal women aged 41 to 60 years. Possible associations with surrogate markers of subclinical atherosclerosis, arterial stiffness, and endothelial function were investigated. Indices of arterial structure included carotid and femoral intima-media thickness and atheromatous plaques presence. Indices of arterial function included flow-mediated dilation of the brachial artery, carotid-femoral pulse wave velocity (PWV), and augmentation index. Total testosterone and free androgen index (FAI) were the most important predictors of common carotid artery intima-media thickness (β = 0.376 and β = 0.236, P < .001 and P = .014, respectively). Similarly, FAI was the only significant independent predictor of PWV (β = 0.254, P = .027) after adjusting for age, smoking, body mass index, homeostasis model assessment of insulin resistance, and blood lipids. Free estrogen index showed a positive association with PWV, independently of age, smoking, and body mass index, but not of homeostasis model assessment of insulin resistance and blood lipids. Age-adjusted levels of DHEAS exhibited a significant independent negative association with measures of augmentation index. Follicle-stimulating hormone, luteinizing hormone, estradiol, sex hormone-binding globulin, and Δ4-androstenedione were not associated with any of the vascular parameters independently of traditional cardiovascular risk factors. Higher serum testosterone and FAI are associated with subclinical atherosclerosis in healthy recently menopausal women. This association is independent of traditional cardiovascular risk factors or insulin resistance. On the contrary, serum DHEAS exhibits a negative association with arterial stiffness.
authors.affiliation: 2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, GR-11528, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Creatsa
authors.forename: Eleni
authors.initials: E
authors.lastname: Armeni
authors.forename: Kimon
authors.initials: K
authors.lastname: Stamatelopoulos
authors.forename: Demetrios
authors.initials: D
authors.lastname: Rizos
authors.forename: Georgios
authors.initials: G
authors.lastname: Georgiopoulos
authors.forename: Maria
authors.initials: M
authors.lastname: Kazani
authors.forename: Andreas
authors.initials: A
authors.lastname: Alexandrou
authors.forename: Spyridon
authors.initials: S
authors.lastname: Dendrinos
authors.forename: Areti
authors.initials: A
authors.lastname: Augoulea
authors.forename: Christos
authors.initials: C
authors.lastname: Papamichael
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki
mesh_terms: D000328:Adult; D000728:Androgens / Q000097:blood*; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000097:blood* / Q000503:physiopathology*; D001783:Blood Flow Velocity / Q000502:physiology; D017536:Carotid Artery, Common / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D006262:Health; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008593:Menopause / Q000097:blood* / Q000502:physiology*; D008875:Middle Aged; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D000728:Androgens