Sader M A, McCredie R J, Griffiths K A, Wishart S M, Handelsman D J, Celermajer D S
Department of Cardiology and Andrology, Royal Prince Alfred Hospital, Sydney, Australia.
Clin Endocrinol (Oxf). 2001 Feb;54(2):175-81. doi: 10.1046/j.1365-2265.2001.01176.x.
To assess prospectively the effects of low dose oestradiol on arterial endothelial and smooth muscle function in healthy men. Oestrogen use is associated with reduced cardiovascular disease in oestrogen-deficient women, however, the vascular effects of low-dose oestradiol in healthy men have not been investigated previously.
Twenty-three men (aged 32 +/- 8 years) were randomized to receive depot implants of testosterone (T) alone (group 1, n = 10), or T with either 10 mg (group 2, n = 7) or 20 mg (group 3, n = 6) of oestradiol (E).
Hormone levels, lipids and vascular reactivity were measured before, 1 month and 6 months after hormone implantation. Using high-resolution ultrasound, brachial artery diameter was measured at rest, during reactive hyperaemia (leading to flow-mediated dilatation, FMD, which is endothelium-dependent) and after sublingual nitroglycerin (GTN, an endothelium-independent dilator).
Oestradiol produced a dose-dependent increase in plasma oestradiol (at 1 month 96 +/- 7, 149 +/- 6, 192 +/- 23 pmol/l in the 3 groups, respectively, P < 0.001 by ANOVA for trend). Minor side-effects (gynaecomastia, nipple tenderness) indicated that 20 mg oestradiol was the maximum tolerated dose. There was also a dose-dependent increase in FMD with oestradiol dose: at 1 month, - 0.2, + 0.2 and + 1.8% for groups 1-3, respectively (P = 0.31 by ANOVA for trend); and at 6 months, - 0.8, + 0.4 and + 2.2% (P = 0.02). The rise in oestradiol levels following treatment correlated with the improvement in FMD (P = 0.01). GTN responses were similar in the 3 groups throughout the study.
In healthy young men, oestradiol supplementation is associated with enhanced arterial endothelial function, a key marker of vascular health.
前瞻性评估低剂量雌二醇对健康男性动脉内皮及平滑肌功能的影响。雌激素的使用与雌激素缺乏女性心血管疾病风险降低相关，但此前尚未研究过低剂量雌二醇对健康男性血管的影响。
23名男性（年龄32±8岁）被随机分组，分别接受单独的睾酮长效植入剂（第1组，n = 10），或睾酮与10 mg（第2组，n = 7）或20 mg（第3组，n = 6）雌二醇的联合植入。
在激素植入前、植入后1个月和6个月测量激素水平、血脂及血管反应性。使用高分辨率超声，在静息状态、反应性充血期间（导致血流介导的血管扩张，FMD，这是内皮依赖性的）以及舌下含服硝酸甘油后（GTN，一种非内皮依赖性扩张剂）测量肱动脉直径。
雌二醇使血浆雌二醇呈剂量依赖性升高（3组在1个月时分别为96±7、149±6、192±23 pmol/l，趋势分析方差分析P<0.001）。轻微副作用（男性乳房发育、乳头触痛）表明20 mg雌二醇是最大耐受剂量。FMD也随雌二醇剂量呈剂量依赖性增加：1个月时，第1 - 3组分别为 - 0.2%、+ 0.2%和 + 1.8%（趋势分析方差分析P = 0.31）；6个月时，分别为 - 0.8%、+ 0.4%和 + 2.2%（P = 0.02）。治疗后雌二醇水平升高与FMD改善相关（P = 0.01）。在整个研究过程中，3组的GTN反应相似。
在健康年轻男性中，补充雌二醇与动脉内皮功能增强相关，这是血管健康的关键指标。
