Relationship between Serum Testosterone Level and Carotid Intima-Media Thickness among Korean Men and Postmenopausal Women
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Given that the role of serum testosterone on incident cardiovascular disease has been uncertain, it is necessary to find out the relationship between serum testosterone and carotid atherosclerosis.Methods: The study participants included 1,302 Korean adults (873 men and 429 postmenopausal women) who participated in the Healthy Twin Study and were not receiving androgen deprivation therapy. The participants were classified into three groups: men aged <40 and ≥40 years and postmenopausal women. Total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations were measured using electrochemiluminescence immunoassays, and free testosterone (cFT) levels were calculated using Vermeulen’s method. Carotid intima-me-dia thickness (IMT) was measured at three levels using a high-resolution B-mode ultrasound equipped with a 7-MHz linear transducer. The associations between sex hormone concentrations and carotid IMT were evaluated using a mixed linear regression analysis.Results: After adjusting for cardiovascular risk factors, TT was found to be inversely associated with common carot-id IMT in men aged ≥40 years, with a 4.5% decrease in common carotid IMT for every one-standard deviation in-crease in TT concentration (P=0.0063). In contrast, TT was not significantly associated with carotid IMT in all seg-ments in men aged <40 years and postmenopausal women. Additionally, SHBG and cFT were not associated with carotid IMT in any segment.Conclusion: The significant association between TT level and common carotid IMT in men aged ≥40 years sug-gests that decreased testosterone levels are involved in the development of atherosclerosis in men.
Abstract
Background: Given that the role of serum testosterone on incident cardiovascular disease has been uncertain, it is necessary to find out the relationship between serum testosterone and carotid atherosclerosis.Methods: The study participants included 1,302 Korean adults (873 men and 429 postmenopausal women) who participated in the Healthy Twin Study and were not receiving androgen deprivation therapy. The participants were classified into three groups: men aged <40 and ≥40 years and postmenopausal women. Total testosterone (TT) and sex hormone-binding globulin (SHBG) concentrations were measured using electrochemiluminescence immunoassays, and free testosterone (cFT) levels were calculated using Vermeulen’s method. Carotid intima-me-dia thickness (IMT) was measured at three levels using a high-resolution B-mode ultrasound equipped with a 7-MHz linear transducer. The associations between sex hormone concentrations and carotid IMT were evaluated using a mixed linear regression analysis.Results: After adjusting for cardiovascular risk factors, TT was found to be inversely associated with common carot-id IMT in men aged ≥40 years, with a 4.5% decrease in common carotid IMT for every one-standard deviation in-crease in TT concentration (P=0.0063). In contrast, TT was not significantly associated with carotid IMT in all seg-ments in men aged <40 years and postmenopausal women. Additionally, SHBG and cFT were not associated with carotid IMT in any segment.Conclusion: The significant association between TT level and common carotid IMT in men aged ≥40 years sug-gests that decreased testosterone levels are involved in the development of atherosclerosis in men.
참고문헌 (29)
- Kaufman JM, "The decline of androgen levels in elderly men and its clinical and therapeutic implications", Endocr Rev, 26, pp.833~876 (2005)
- Harman SM, "Longitudinal effects of aging on serum total and free testosterone levels in healthy men: Baltimore Longitudinal Study of Aging", J Clin Endocrinol Metab, 86, pp.724~731 (2001)
- Kalyani RR, "Androgen deficiency, diabetes, and the metabolic syndrome in men", Curr Opin Endocrinol Diabetes Obes, 14, pp.226~234 (2007)
- Srinath R, "Endogenous testosterone and its relationship to preclinical and clinical measures of cardiovascular disease in the atherosclerosis risk in communities study", J Clin Endocrinol Metab, 100, pp.1602~1608 (2015)
- Malkin CJ, "Low serum testosterone and increased mortality in men with coronary heart disease", Heart, 96, pp.1821~1825 (2010)
- Park BJ, "Inverse relationship between bioavailable testosterone and subclinical coronary artery calcification in non-obese Korean men", Asian J Androl, 14, pp.612~615 (2012)
- Akishita M, "Low testosterone level as a predictor of cardiovascular events in Japanese men with coronary risk factors", Atherosclerosis, 210, pp.232~236 (2010)
- Zhao D, "Endogenous sex hormones and incident cardiovascular disease in post-menopausal women", J Am Coll Cardiol, 71, pp.2555~2566 (2018)
- Rexrode KM, "Sex hormone levels and risk of cardiovascular events in postmenopausal women", Circulation, 108, pp.1688~1693 (2003)
- Laughlin GA, "Extremes of endogenous testosterone are associated with increased risk of incident coronary events in older women", J Clin Endocrinol Metab, 95, pp.740~747 (2010)
- Sievers C, "Low testosterone levels predict all-cause mortality and cardiovascular events in women : a prospective cohort study in German primary care patients", Eur J Endocrinol, 163, pp.699~708 (2010)
- Lorenz MW, "Prediction of clinical cardiovascular events with carotid intima-media thickness : a systematic review and meta-analysis", Circulation, 115, pp.459~467 (2007)
- Ren L, "Impact of cardiovascular risk factors on carotid intima-media thickness and degree of severity : a cross-sectional study", PLoS One, 10, pp.e0144182~ (2015)
- Soisson V, "Low plasma testosterone and elevated carotid intima-media thickness : importance of low-grade inflammation in elderly men", Atherosclerosis, 223, pp.244~249 (2012)
- Tsujimura A, "Low serum free testosterone level is associated with carotid intima-media thickness in middle-aged Japanese men", Endocr J, 59, pp.809~815 (2012)
- Vikan T, "Endogenous sex hormones and the prospective association with cardiovascular disease and mortality in men : the Tromso Study", Eur J Endocrinol, 161, pp.435~442 (2009)
- Gombojav B, "The Healthy Twin Study, Korea updates : resources for omics and genome epidemiology studies", Twin Res Hum Genet, 16, pp.241~245 (2013)
- Vermeulen A, "A critical evaluation of simple methods for the estimation of free testosterone in serum", J Clin Endocrinol Metab, 84, pp.3666~3672 (1999)
- Rincon F, "Incidence and risk factors of intracranial atherosclerotic stroke : the Northern Manhattan Stroke Study", Cerebrovasc Dis, 28, pp.65~71 (2009)
- Svartberg J, "Low testosterone levels are associated with carotid atherosclerosis in men", J Intern Med, 259, pp.576~582 (2006)
- Makinen J, "Increased carotid atherosclerosis in andropausal middleaged men", J Am Coll Cardiol, 45, pp.1603~1608 (2005)
- Khaw KT, "Blood pressure and endogenous testosterone in men : an inverse relationship", J Hypertens, 6, pp.329~332 (1988)
- Grossmann M, "Low testosterone in men with type 2 diabetes : significance and treatment", J Clin Endocrinol Metab, 96, pp.2341~2353 (2011)
- Haring R, "Prediction of metabolic syndrome by low serum testosterone levels in men : results from the study of health in Pomerania", Diabetes, 58, pp.2027~2031 (2009)
- Fu L, "Relationship between testosterone and indexes indicating endothelial function in male coronary heart disease patients", Asian J Androl, 10, pp.214~218 (2008)
- Marin P, "Assimilation and mobilization of triglycerides in subcutaneous abdominal and femoral adipose tissue in vivo in men : effects of androgens", J Clin Endocrinol Metab, 80, pp.239~243 (1995)
- Handelsman DJ, "Free testosterone : pumping up the tires or ending the free ride?", Endocr Rev, 38, pp.297~301 (2017)
- Goldman AL, "A reappraisal of testosterone’s binding in circulation : physiological and clinical implications", Endocr Rev, 38, pp.302~324 (2017)
- Bhasin S, "Sex hormone-binding globulin, but not testosterone, is associated prospectively and independently with incident metabolic syndrome in men : the framingham heart study", Diabetes Care, 34, pp.2464~2470 (2011)