Circulating Estradiol Is an Independent Predictor of Progression of Carotid Artery Intima-Media Thickness in Middle-Aged Men

• Published in: The journal of clinical endocrinology and metabolism Vol. 91; no. 11; pp. 4433 - 4437
• Main Authors: Tivesten, Åsa, Hulthe, Johannes, Wallenfeldt, Karin, Wikstrand, John, Ohlsson, Claes, Fagerberg, Björn
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01.11.2006; Copyright by The Endocrine Society
• Subjects: Biological and medical sciences; Carotid Arteries - anatomy & histology; Carotid Artery Diseases - diagnosis; Carotid Artery Diseases - epidemiology; Carotid Artery Diseases/diagnosis/epidemiology; Cholesterol; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Cohort Studies; Disease Progression; Endocrinopathies; Estradiol - blood; Fundamental and applied biological sciences. Psychology; HDL/blood; Health Status Indicators; Humans; LDL/blood; Longitudinal Studies; Male; MEDICAL AND HEALTH SCIENCES; Medical sciences; MEDICIN OCH HÄLSOVETENSKAP; Middle Aged; Prognosis; Risk Factors; Sex Hormone-Binding Globulin - analysis; Testosterone - blood; Tunica Intima - anatomy & histology; Tunica Media - anatomy & histology; Vertebrates: endocrinology; Human; Middle age; Estrogen; Male; Estradiol; Ovarian hormone; Artery; Thickness; Blood vessel; Carotid; Intima; Adult; Circulatory system; Sex steroid hormone; Predictive factor; Vascular wall; Endocrinology
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2006-0932

Context: 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. Objective: 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. Intervention: There was no intervention. Main Outcome Measures: 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. Results: 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). Conclusions: 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.