title: Impact of elevated serum estradiol/free testosterone ratio on male varicose veins in a prospective study.
abstract: OBJECTIVE
  Although some studies indicate an association between increased levels of estradiol and varicose veins in women, the role of sex hormones on varicose veins have a question mark in men.
  
  
  METHODS
  We investigated estradiol-2/free testosterone (E2/fT) ratio relationship on varicosity in 100 male patients dividing them into two groups. Group A (n = 46) had varicose veins with endocrinological problems, especially infertility, whereas group B (n = 54) also had varicose veins but no endocrinological problems. Venous blood samples were drawn from both groups in the morning to detect the levels of serum estradiol (E2), androstenedione, dehydroepiandrostenedione sulphate and free testosterone (fT). Patient history, physical examination, colour duplex ultrasound of both limbs and classification of CEAP were performed in both groups. Serum E2/fT ratio was calculated in correspondence with CEAP classification. CEAP classification is the varicosity classification, and it is concerned about the clinical class (C), etiology (E), anatomical distribution (A) and underlying pathophysiology (P).
  
  
  RESULTS
  E2/fT ratio was significantly higher in group A (4.18 ± 0.54) compared with group B (2.98 ± 0.36). Moreover, there is a high correlation between serum E2/fT ratio and CEAP clinical classification in group A (4) compared with group B (2).
  
  
  CONCLUSIONS
  Serum E2/fT ratio is associated with varicose veins in male patients.
authors.affiliation: Department of Cardiovascular Surgery, Faculty Of Medicine, 18 Mart University, Canakkale, Turkey. sedatozcan78@hotmail.com.
authors.forename: Sedat
authors.initials: S
authors.lastname: Özcan
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Dolunay
authors.initials: D
authors.lastname: Odabasi
authors.affiliation: Department of Cardiovascular Surgery, Faculty Of Medicine, 18 Mart University, Canakkale, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Kurt
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Ali Kemal
authors.initials: AK
authors.lastname: Gür
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Aysegul
authors.initials: A
authors.lastname: Kunt
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Balaharoglu
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Alper Sami
authors.initials: AS
authors.lastname: Kunt
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015984:Causality; D015897:Comorbidity; D004958:Estradiol / Q000097:blood*; D006801:Humans; D007248:Infertility, Male / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D054526:Men's Health / Q000706:statistics & numerical data; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D013739:Testosterone / Q000097:blood*; D014421:Turkey / Q000453:epidemiology; D014648:Varicose Veins / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D015415:Biomarkers; D013739:Testosterone; D004958:Estradiol
keywords: CEAP classification; Chronic venous insufficiency; Sex hormones; Varicose veins