Low levels of endogtenous androgens increase the risk of atherosclerosis in elderly men: The Rotterdam study
Low levels of endogtenous androgens increase the risk of atherosclerosis in elderly men: The Rotterdam study
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DOI：
10.1210/jc.87.8.3632
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发表时间：
2002-08-01
影响因子：
5.8
通讯作者：
Pols, HAP
中科院分区：
文献类型：
--
作者：
Hak, AE;Witteman, JCM;Pols, HAP
无论男性还是女性，循环雄激素水平都会随着年龄的增长而下降。到目前为止，几项关于内源性雄激素水平与动脉粥样硬化之间关系的小型研究结果并不一致。在以人群为基础的鹿特丹研究中，我们调查了 1,032 名 55 岁及以上不吸烟男性和女性的硫酸脱氢表雄酮 (DHEAS) 水平以及总睾酮和生物可利用睾酮水平与主动脉粥样硬化的关系。主动脉粥样硬化通过腹主动脉钙化沉积物的放射学检测来评估，这已被证明反映了内膜动脉粥样硬化。相对于总睾酮和生物利用度睾酮水平处于最低三分位的男性，这些激素水平处于最高三分位的男性的年龄调整相对风险为 0.4 [95% 置信区间 (0)、0.2-0.91 和 0.2 （CI，0.1-0.7），分别表示是否存在严重主动脉粥样硬化。女性相应的相对风险为 3.7 (CI, 1.211.6) 和 2.3 (CI, 0.7-7.8)。对心血管疾病危险因素的额外调整并没有对男性的结果产生实质性影响，而在女性中，这种关联被稀释。在随后的三分位数中具有总睾酮水平和生物可利用睾酮水平的男性在 6.5 年（SD +/- 0.5 年）随访后测量也能防止主动脉粥样硬化进展（趋势 P = 0.02）。无论男性还是女性，DHEAS 水平与严重主动脉粥样硬化之间均未发现明显关联。在男性中，较高水平的 DHEAS 被认为对主动脉粥样硬化的进展具有保护作用，但相应的趋势检验并未达到统计学显着性。总之，我们发现男性睾酮水平与主动脉粥样硬化之间存在独立的负相关关系。在女性中，睾酮水平与主动脉粥样硬化之间的正相关很大程度上是由于不良心血管疾病危险因素。
In both men and women, circulating androgen levels decline with advancing age. Until now, results of several small studies on the relationship between endogenous androgen levels and atherosclerosis have been inconsistent.In the population-based Rotterdam Study, we investigated the association of levels of dehydroepiandrosterone sulfate (DHEAS) and total and bioavailable testosterone with aortic atherosclerosis among 1,032 nonsmoking men and women aged 55 yr and over. Aortic atherosclerosis was assessed by radiographic detection of calcified deposits in the abdominal aorta, which have been shown to reflect intimal atherosclerosis.Relative to men with levels of total and bioavailable testosterone in the lowest tertile, men with levels of these hormones in the highest tertile had age-adjusted relative risks of 0.4 [95% confidence interval (0), 0.2-0.91 and 0.2 (CI, 0.1-0.7), respectively, for the presence of severe aortic atherosclerosis. The corresponding relative risks for women were 3.7 (CI, 1.211.6) and 2.3 (CI, 0.7-7.8). Additional adjustment for cardio-vascular disease risk factors did not materially affect the results in men, whereas in women the associations diluted. Men with levels of total and bioavailable testosterone in subsequent tertiles were also protected against progression of aortic atherosclerosis measured after 6.5 yr (SD +/- 0.5 yr) of follow-up (P for trend = 0.02). No clear association between levels of DHEAS and presence of severe aortic atherosclerosis was found, either in men or in women. In men, a protective effect of higher levels of DHEAS against progression of aortic atherosclerosis was suggested, but the corresponding test for trend did not reach statistical significance.In conclusion, we found an independent inverse association between levels of testosterone and aortic atherosclerosis in men. In women, positive associations between levels of testosterone and aortic atherosclerosis were largely due to adverse cardiovascular disease risk factors.