Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Atherosclerosis. 2022 Nov;361:34-40. doi: 10.1016/j.atherosclerosis.2022.09.006. Epub 2022 Sep 24.
Evidence for the association of total estradiol (E2) with cardiovascular disease (CVD) in young men is limited. We investigated the association of total E2 or free estradiol (FE2) and CVD mortality in a nationally representative multiracial sample of young and middle-aged men in the United States.
Data were from 954 men without CVD, cancer, diabetes and not on androgen therapy or taking anabolic steroids, who participated in the National Health and Nutrition Examination Survey (1988-1991), for whom E2 was measured, and were followed for mortality through to 2015. Fasting serum levels of E2 were measured using competitive electrochemiluminescence immunoassays. Free estradiol was estimated from the levels of estradiol, sex hormone binding globulin, and albumin. International Classification of Diseases codes were used to define CVD mortality. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI).
The average age of participants at baseline was 35.7 ± 11.6 years, with 11% and 6% reporting Black and Hispanic race and ethnicity, respectively. During a median follow-up of 25.2 years, 40 CVD deaths were recorded. Controlling for baseline demographic and CVD risk factors, and total testosterone levels, a 1 standard deviation decrement in log E2 (HR: 2.33, 95%CI: 1.11-5.00) or FE2 (HR: 1.89, 95%CI: 1.01-3.57) was associated with elevated risk of CVD mortality. This elevated risk was largely limited to non-Hispanic White men.
In this study, low levels of E2 or FE2 were associated with elevated risk of CVD mortality.
关于总雌二醇（E2）与心血管疾病（CVD）之间关联的证据在年轻男性中有限。我们在美国一个具有全国代表性的、多种族的年轻和中年男性样本中，研究了总 E2 或游离雌二醇（FE2）与 CVD 死亡率之间的关系。
数据来自 954 名没有 CVD、癌症、糖尿病且未接受雄激素治疗或服用合成代谢类固醇的男性，他们参加了 1988-1991 年的国家健康和营养调查（NHANES），并对他们进行了随访，直到 2015 年记录他们的死亡率。使用竞争性电化学发光免疫测定法测量 E2 的空腹血清水平。游离雌二醇是根据雌二醇、性激素结合球蛋白和白蛋白的水平来估算的。使用国际疾病分类代码来定义 CVD 死亡率。使用 Cox 回归模型计算风险比（HR）和 95%置信区间（CI）。
参与者的平均基线年龄为 35.7±11.6 岁，分别有 11%和 6%报告为黑人和西班牙裔种族和民族。在中位随访 25.2 年期间，记录了 40 例 CVD 死亡。在控制基线人口统计学和 CVD 风险因素以及总睾酮水平后，log E2（HR：2.33，95%CI：1.11-5.00）或 FE2（HR：1.89，95%CI：1.01-3.57）降低一个标准差与 CVD 死亡率升高相关。这种升高的风险主要局限于非西班牙裔白人男性。
在这项研究中，E2 或 FE2 水平较低与 CVD 死亡率升高相关。
