title: Association of endogenous testosterone with subclinical atherosclerosis in men: the multi-ethnic study of atherosclerosis.
abstract: OBJECTIVE
  Whether endogenous sex hormones play a role in cardiovascular disease (CVD) risk in men is unclear. Few studies have examined associations of sex hormones with atherosclerosis measured by coronary artery calcium score (CACS) and carotid intima-media thickness (cIMT). We evaluated the association of testosterone (T) and other sex hormones with CACS and cIMT.
  
  
  METHODS
  Using the large multi-ethnic cohort of 3164 men without known CVD in the Multi-Ethnic Study of Atherosclerosis (MESA), cross-sectional associations of tertiles of endogenous sex hormones with CACS and cIMT were analysed.
  
  
  RESULTS
  In regard to CAC, there was a significant negative trend (P-trend = 0·02) for CACS>0 over tertiles of free T (FT) with RRs (95% CI) for the lowest to highest tertiles. There was also a marginally significant positive trend (P-trend = 0·06) for CACS>0 over tertiles of sex hormone-binding globulin (SHBG) with RRs for the lowest to highest tertiles. There were no significant associations with CACS >0 for tertiles of TT (Total T), bioavailable T (BT), oestradiol (E2) and dehydroepiandrosterone (DHEA). There was significantly higher log CACS after adjustment for CVD risk factors for lower TT levels, compared to higher levels, using 9·54 and 10·4 nmol/l as cut-off points. In regard to cIMT, there was a significant positive trend (P = 0·003) in mean cIMT over the tertiles of BT, but not for TT, FT, E2, DHEA and SHBG. There was significantly lower cIMT after adjustment for CVD risk factors for lower TT levels compared to higher levels.
  
  
  CONCLUSIONS
  In a population of male subjects with no known CVD, lower FT is associated with higher RR of CACS>0 and lower TT is associated with higher log CACS. Lower BT and TT are associated with lower cIMT. While these findings support the positive correlation between low T and coronary atherosclerosis, the opposite findings on cIMT warrant further evaluation.
authors.affiliation: Los Angeles Biomedical Research Institute, UCLA School of Medicine, Torrance, CA, USA.
authors.forename: Bahram
authors.initials: B
authors.lastname: Khazai
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Sherita Hill
authors.initials: SH
authors.lastname: Golden
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Colangelo
authors.affiliation: Los Angeles Biomedical Research Institute, UCLA School of Medicine, Torrance, CA, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Swerdloff
authors.affiliation: Los Angeles Biomedical Research Institute, UCLA School of Medicine, Torrance, CA, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Wang
authors.affiliation: Los Angeles Biomedical Research Institute, UCLA School of Medicine, Torrance, CA, USA.
authors.forename: Lily
authors.initials: L
authors.lastname: Honoris
authors.affiliation: American Cancer Society, Atlanta, GA, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Gapstur
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Pamela
authors.initials: P
authors.lastname: Ouyang
authors.affiliation: University of Vermont, Burlington, VT, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.affiliation: Los Angeles Biomedical Research Institute, UCLA School of Medicine, Torrance, CA, USA.
authors.forename: Dong
authors.initials: D
authors.lastname: Li
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Kopp
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Vaidya
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Adrian
authors.initials: A
authors.lastname: Dobs
authors.affiliation: Los Angeles Biomedical Research Institute, UCLA School of Medicine, Torrance, CA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Budoff
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian / Q000706:statistics & numerical data; D050197:Atherosclerosis / Q000097:blood* / Q000208:ethnology* / Q000473:pathology; D002118:Calcium / Q000378:metabolism; D059168:Carotid Intima-Media Thickness; D003331:Coronary Vessels / Q000378:metabolism; D003687:Dehydroepiandrosterone / Q000097:blood; D004958:Estradiol / Q000097:blood; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data*; D012307:Risk Factors; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D013739:Testosterone / Q000097:blood*; D014481:United States; D044465:White People / Q000706:statistics & numerical data
chemical_list: D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D003687:Dehydroepiandrosterone; D004958:Estradiol; D002118:Calcium