Tivesten Asa, Hulthe Johannes, Wallenfeldt Karin, Wikstrand John, Ohlsson Claes, Fagerberg Björn
Institute of Internal Medicine, The Wallenberg Laboratory for Cardiovascular Research, Bruna Stråket 16, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden.
J Clin Endocrinol Metab. 2006 Nov;91(11):4433-7. doi: 10.1210/jc.2006-0932. Epub 2006 Aug 29.
Estrogen treatment of men with prostate cancer is associated with increased cardiovascular morbidity and mortality; however, the role of endogenous estrogen levels for atherosclerotic disease in men is unknown.
The objective of the study was to determine whether endogenous serum estradiol (E2) levels predict the progression of carotid artery intima-media thickness in men.
DESIGN, SETTING AND PARTICIPANTS: This was a population-based, prospective cohort study (the Atherosclerosis and Insulin Resistance study) conducted in Göteborg, Sweden, among 313 Caucasian men without cardiovascular or other clinically overt diseases. Carotid artery intima-media thickness, an index of preclinical atherosclerosis, was measured by ultrasound at baseline (58 yr of age) and after 3 yr of follow-up. Serum sex hormone levels and cardiovascular risk factors (body mass index, waist to hip ratio, systolic blood pressure, serum triglycerides, plasma c-peptide, and smoking status) were assessed at study entry.
There was no intervention.
Association between baseline total and free E2 levels and progression of carotid intima-media thickness over 3 yr with adjustments for cardiovascular risk factors was measured.
In univariate analyses, both total and free E2 levels at baseline were positively associated with the annual change in intima-media thickness. In linear regression models including E2 and cardiovascular risk factors, low-density lipoprotein and high-density lipoprotein cholesterol and E2 were identified as independent predictors of progression of carotid artery intima-media thickness (total E2 beta = 0.187, P = 0.001; and free E2 beta = 0.183, P = 0.003).
Circulating E2 is a predictor of progression of carotid artery intima-media thickness in middle-aged men. Further studies are needed to investigate the role of endogenous E2 for incident cardiovascular disease events.
对患有前列腺癌的男性进行雌激素治疗与心血管疾病发病率和死亡率增加有关；然而，内源性雌激素水平在男性动脉粥样硬化疾病中的作用尚不清楚。
本研究的目的是确定内源性血清雌二醇（E2）水平是否可预测男性颈动脉内膜中层厚度的进展。
设计、地点和参与者：这是一项基于人群的前瞻性队列研究（动脉粥样硬化与胰岛素抵抗研究），在瑞典哥德堡对313名无心血管疾病或其他临床显性疾病的白种男性进行。通过超声在基线（58岁）和随访3年后测量颈动脉内膜中层厚度，这是临床前期动脉粥样硬化的一个指标。在研究开始时评估血清性激素水平和心血管危险因素（体重指数、腰臀比、收缩压、血清甘油三酯、血浆C肽和吸烟状况）。
无干预措施。
测量基线总E2水平和游离E2水平与3年内颈动脉内膜中层厚度进展之间的关联，并对心血管危险因素进行校正。
在单变量分析中，基线时总E2水平和游离E2水平均与内膜中层厚度的年变化呈正相关。在包括E2和心血管危险因素的线性回归模型中，低密度脂蛋白、高密度脂蛋白胆固醇和E2被确定为颈动脉内膜中层厚度进展的独立预测因素（总E2的β值 = 0.187，P = 0.001；游离E2的β值 = 0.183，P = 0.003）。
循环E2是中年男性颈动脉内膜中层厚度进展的预测因素。需要进一步研究来探讨内源性E2在心血管疾病事件发生中的作用。
