Increased Carotid Atherosclerosis in Andropausal Middle-Aged Men

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• 作者：Juuso Mä ; kinen ; Mikko J. Jä ; rvisalo ; Pasi Pö ; llä ; nen ; Antti Perheentupa ; Kerttu Irjala ; Markku Koskenvuo ; Juha Mä ; kinen ; Ilpo Huhtaniemi ; Olli T. Raitakari
• 刊名：Journal of the American College of Cardiology
• 出版年：2005
• 出版时间：17 May 2005
• 年：2005
• 卷：45
• 期：10
• 页码：1603-1608
• 全文大小：124 K

文摘

Objectives

This study examined the association between carotid artery intima-media thickness (IMT), serum sex hormone levels, and andropausal symptoms in middle-aged men.

Background

Male sex hormones may play a dual role in the pathogenesis of atherosclerosis in men by carrying both proatherogenic and atheroprotective effects.

Methods

We studied 239 40- to 70-year-old men (mean ± SD: 57 ± 8 years) who participated in the Turku Aging Male Study and underwent serum lipid and sex hormone measurements. Ninety-nine men (age 58 ± 7 years) were considered andropausal (i.e., serum testosterone <9.8 nmol/l or luteinizing hormone [LH] >6.0 U/l and testosterone in the normal range), and in both situations, they had subjective symptoms of andropause (a high symptom score in questionnaire). Three were excluded because of diabetes. The rest of the men (age 57 ± 8 years) served as controls. Carotid IMT was determined using high-resolution B-mode ultrasound, and serum testosterone, estradiol (E₂), LH, and sex hormone-binding globulin were measured using standard immunoassays.

Results

Andropausal men had a higher maximal IMT compared with controls in the common carotid (1.08 ± 0.34 vs. 1.00 ± 0.23, p < 0.05) and in the carotid bulb (1.44 ± 0.48 vs. 1.27 ± 0.35, p = 0.003). Common carotid IMT correlated inversely with serum testosterone (p = 0.003) and directly with LH (p = 0.006) in multivariate models adjusted for age, total cholesterol, body mass index, blood pressure, and smoking.

Conclusions

Middle-aged men with symptoms of andropause, together with absolute or compensated (as reflected by high normal to elevated LH) testosterone deficiency, show increased carotid IMT. These data suggest that normal testosterone levels may offer protection against the development of atherosclerosis in middle-aged men.