BACKGROUND

Men are more prone to develop coronary artery disease (CAD) than women and the mechanism of this different susceptibility is not well elucidated. The aim of this study was to evaluate the relationship between serum levels of several sex hormones and serum levels of lipoproteins, as well as the association between sex hormones and clinical covariates in men with stable coronary artery disease.

METHODS

Study population consisted of 111 men (mean age 55 years) with stable coronary artery disease. In all patients levels of testosterone, dehydroepiandrosterone sulfate (DHEA-S), estradiol, sex hormone binding globuline (SHBG), luteinizing hormone (LH) and follicle stimulating hormone (FSH) were measured and free testosterone index (FTI) was calculated knowing SHBG. Standard lipid analysis included total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. The extent of coronary artery disease was defined using semiquantitative coronary angiography score.

RESULTS

Significant positive correlations were found between estradiol levels and levels of total cholesterol (r = 0.31; p = 0.005), LDL-cholesterol (r = 0.32; p=0.004), total cholesterol/HDL ratio (r = 0.26; p = 0.020), and triglycerides (r = 0.24; p = 0.030), whereas no significant association was found between levels of these lipids and testosterone or DHEA levels. HDL cholesterol showed a significant association with levels of FSH (r = 0.23; p = 0.03) and LH (r = 0.25; p = 0.02).

CONCLUSIONS

Our results indicate a possible role of estradiol in promoting the development of atherogenic lipid milieu in men with CAD. Simultaneously, the observed association between increased FSH and LH levels with increased levels of HDL cholesterol might suggest a protective effect of these hormones.