title: Circulating Sex Steroids and Vascular Calcification in Community-Dwelling Men: The Framingham Heart Study.
abstract: The relationship between sex steroids and atherosclerosis is poorly understood.
  
  
  
  To describe the association of serum total T (TT), calculated free T (cFT), estrone (E1), estradiol (E2), and SHBG to vascular calcification in adult men.
  
  
  
  Observational study (Framingham Heart Study). Analyses are cross-sectional. TT, E1, and E2 were measured by liquid chromatography-tandem mass spectrometry, and SHBG by immunofluorometric assay. Estimates of association were obtained by Tobit regression, which acknowledges the influence of floor effects on outcomes.
  
  
  
  General community.
  
  
  
  A total of 1654 community-dwelling men from the Offspring and Third Generation cohorts of the Framingham Heart Study.
  
  
  
  Coronary artery calcification (CAC), abdominal aortic calcification, and thoracic aortic calcification were measured by computed tomography.
  
  
  
  Mean (standard deviation [SD]) age was 49 (10) years. Mean (SD) TT, cFT, and SHBG were: 616 (224) ng/dL, 111 (45) pg/mL, and 46 (23) nmol/L, respectively. Mean (SD) E2 and E1 were 28 (10) and 39 (14) pg/mL. Vascular calcification at all sites was negatively associated with TT and cFT and positively associated with E2 and E1. A 100-ng/dL between-subjects increase in TT was associated with a mean (95% confidence interval) age-adjusted difference in CAC of -23% (-41%, -4%) (P = .02). After model adjustment for other cardiovascular risk factors, the estimated associations between T and vascular calcification scores were statistically nonsignificant.
  
  
  
  Decreased circulating T and E2 levels are associated with an age-adjusted increase in CAC, but these associations appear to express relationships either attributable to or mediated by established cardiovascular risk factors.
authors.affiliation: Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Travison
authors.affiliation: Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Donnell
authors.affiliation: Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Shalender
authors.initials: S
authors.lastname: Bhasin
authors.affiliation: Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Massaro
authors.affiliation: Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.affiliation: Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.affiliation: Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Ralph B
authors.initials: RB
authors.lastname: D'Agostino
authors.affiliation: Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215.
authors.forename: Shehzad
authors.initials: S
authors.lastname: Basaria
mesh_terms: D000328:Adult; D000375:Aging / Q000097:blood; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood*; D004970:Estrone / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood*; D061205:Vascular Calcification / Q000097:blood* / Q000000981:diagnostic imaging
chemical_list: D012738:Sex Hormone-Binding Globulin; D004970:Estrone; D013739:Testosterone; D004958:Estradiol