title: The effect of hormone therapy on biochemical and ultrasound parameters associated with atherosclerosis in 46,XY DSD individuals with female phenotype.
abstract: The aim of this study was to evaluate the effect of hormone therapy (HT) in the endothelial function of 46,XY disorders of sexual development (DSD) patients with female phenotype. Biochemical and ultrasound measurements were performed in 20 patients at initiation of oral 2 mg 17β-estradiol/1 mg norethisterone acetate, and after 6 months of therapy. Lipid profile, including total cholesterol (TC), LDL, HDL, triglycerides (TG) and Atherogenic Index of Plasma (AIP), as well as levels of VE-Cadherin, E-Selectin, Thrombomodulin and vWf were determined. Ultrasonographic examinations included evaluation of flow-mediated dilatation (FMD) and measurement of Carotid and Femoral Intima Media Thickness (IMT). HT raised HDL (35.4 mg/dl versus 40.1 mg/dl, p = 0.019) while lowering TG (166 mg/dl versus 109 mg/dl, p = 0.026) and AIP (0.24 versus 0.04, p = 0.007). No changes were noted in TC and LDL (215.7 mg/dl versus 192.25 mg/dl and 87.46 mg/dl versus 76.35 mg/dl, respectively). There was significant reduction of VE-Cadherin (4.05 ng/ml versus 2.20 ng/ml, p = 0.002) and E-selectin (73.98 ng/ml versus 56.73 ng/ml, p = 0.004). No change was observed in Thrombomodulin and vWf (11.76 ng/ml versus 13.90 ng/ml and 80.75% versus 79.55%, respectively). FMD improved significantly (5.4% versus 8.15%, p = 0.003), while only carotid bulb IMT decreased significantly (0.65 mm versus 0.60 mm, p = 0.018). Overall, HT was found to improve biochemical and ultrasound markers of endothelial function in 46,XY DSD patients with female phenotype.
authors.affiliation: Division of Pediatric, Adolescent Gynecology and Reconstructive Surgery, 2nd Department of Obstetrics and Gynecology, University of Athens, Medical School , "Aretaieion" Hospital, Athens , Greece .
authors.forename: Pantelis
authors.initials: P
authors.lastname: Tsimaris
authors.forename: Efthimios
authors.initials: E
authors.lastname: Deligeoroglou
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Athanasopoulos
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Economou
authors.forename: Kimon
authors.initials: K
authors.lastname: Stamatelopoulos
authors.forename: Demetrios
authors.initials: D
authors.lastname: Rizos
authors.forename: Christos
authors.initials: C
authors.lastname: Papamichael
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki
authors.forename: George
authors.initials: G
authors.lastname: Mastorakos
authors.forename: George
authors.initials: G
authors.lastname: Creatsas
mesh_terms: D000293:Adolescent; D000328:Adult; D013734:Androgen-Insensitivity Syndrome / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D050197:Atherosclerosis / Q000097:blood / Q000000981:diagnostic imaging; D004338:Drug Combinations; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000187:drug effects*; D004958:Estradiol / Q000008:administration & dosage / Q000494:pharmacology*; D004967:Estrogens / Q000008:administration & dosage / Q000494:pharmacology*; D005260:Female; D006061:Gonadal Dysgenesis, 46,XY / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008297:Male; D009640:Norethindrone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D000077563:Norethindrone Acetate; D011372:Progestins / Q000008:administration & dosage / Q000494:pharmacology*; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D004967:Estrogens; D011372:Progestins; D004958:Estradiol; D000077563:Norethindrone Acetate; D009640:Norethindrone
keywords: Complete androgen insensitivity syndrome; E-selectin; VE-cadherin; flow-mediated dilatation; gonadal dysgenesis; intima media thickness; swyer syndrome; vWf