This study was carried out in order to investigate the relationship between endogenous sex steroid hormones and coronary artery disease (CAD). Three hundred and thirty-seven men undergoing coronary angiography were enrolled in the study. Total testosterone, estradiol, free testosterone levels in men with CAD (n = 213) were compared to those of men without CAD (n = 124). No significant differences were found in the serum concentrations of estradiol, total and free testosterone and serum lipid profile between the two groups. Total and free testosterone were negatively (p < 0.05 to p < 0.001) and estradiol was positively (p < 0.05) correlated with age in both groups. Total cholesterol and low-density-lipoprotein levels were positively correlated with the level of free testosterone (r = 0.221, p < 0.01; r = 0.173, p < 0.05, respectively), and high-density-lipoprotein levels were negatively correlated with total testosterone in patients with CAD (r = –0.166, p < 0.05). The results of this study do not support the role of sex steroid hormones in CAD. However, the relationship between sex steroids and serum lipids needs further clarification.

Keywords:
Coronary artery disease, Testosterone, Estradiol, Lipoproteins
1.
Heller RF, Jacobs HS, Vermeulen A, Deslypere JP: Androgens, estrogens, and coronary heart disease. Br Med J 1981;282:438–439.
2.
Barth JD, Jansen H, Hugenholtz PG, Birkenhager JC: Post-heparin lipases, lipids and related hormones in men undergoing coronary arteriography to assess atherosclerosis. Atherosclerosis 1983;48:235–241.
3.
Breier C, Mühlberger V, Drexel H, Herold M, Lisch HJ, Knapp E, Braunsteiner H: Essential role of post-heparin lipoprotein lipase activity and of plasma testosterone in coronary artery disease. Lancet 1985;i:1242–1244.
4.
Freedman DS, O’Brien TR, Flanders DW, DeStefano F, Barboriak JJ: Relation of serum testosterone levels to high-density lipoprotein cholesterol and other characteristics in men. Arterioscler Thromb Vasc Biol 1991;11:307–315.
5.
Khaw KT, Barret-Connor E: Endogenous sex hormones, high-density lipoprotein cholesterol, and other lipoprotein fractions in men. Arterioscler Thromb Vasc Biol 1991;11:489–494.
6.
Philips GB, Castelli WP, Abbott RD, McNamara PN: Association of hyperestrogenemia and coronary heart disease in men in the Framingham cohort. Am J Med 1983;74:863–866.
7.
Entrican JH, Beach C, Carroll D, Kenmure ACF, Klopper A, Mackie M, Dougles AS: Raised plasma oestradiol and oestrone levels in young survivors of myocardial infarction. Lancet 1978;ii:487–490.
8.
Klaiber EL, Broverman DM, Haffajee CI, Hochman JS, Sacks GM, Dalen JE: Serum estrogen levels in men with acute myocardial infarction. Am J Med 1982;73:872–881.
9.
Luria MH, Johnson MW, Pego R, Seuc CA, Manubens SJ, Wieland MR, Wieland RG: Relationship between sex hormones, myocardial infarction, and occlusive coronary disease. Arch Intern Med 1982;142:42–44.
10.
Mendoza SG, Zerpa A, Carrasco H, Colmenares O, Rangel AS, Gartside PS, Kashyap ML: Estradiol, testosterone, apolipoproteins, lipoprotein cholesterol, and lipolytic enzymes in men with premature myocardial infarction and angiographically assessed coronary occlusion. Artery 1983;12:1–23.
11.
Takeda R, Ikeda M, Miyamori I, Matsubara T, Okamoto S, Koshida H, Morise T, Nunoda S, Nakayama A, Genda A: Relationship of plasma levels of estradiol to the severity of coronary arteriosclerosis. Atherosclerosis 1987;68:175–176.
12.
Veterans Administration Cooperative Urological Research Group. Treatment and survival of patients with cancer of the prostate. Surg Gynecol Obstet 1967;124:1011–1017.
13.
Coronary Drug Project Research Group: The coronary drug project: Findings leading to discontinuation of the 2.5 mg/day estrogen group. JAMA 1973;226:863–869.
14.
Chute CG, Baron JA, Plymate SR, Kiel DP, Pavia AT, Lozner EZ, O’Keefe T, MacDonald GJ: Sex hormones and coronary artery disease. Am J Med 1987;83:853–859.
15.
Goldberg RJ, Gore JM, Ziwe M, Brady P, Klaiber E, Broverman D, Ockene IS, Dalen JE: Serum estradiol and coronary artery disease. Am J Med 1987;82:1–7.
16.
Gensini GG: Coronary Arteriography. Mount Kisco, Futura Publishing, 1975.
17.
Heller RF, Jacobs HS, Vermeulen A, Deslypere JP: Androgens, oestrogens, and coronary heart disease. BMJ 1981;282:438–439.
18.
Labropoulas B, Velonakis E, Oekonomakos P, Laskaris J, Katsimades D: Serum sex hormones in patients with coronary disease and their relationship to known factors causing atherosclerosis. Cardiology 1982;69:90–103.
19.
Philips GB: Evidence for hyperestrogenemia as risk factor for myocardial infarction in men. Lancet 1976;ii:14–18.
20.
Poggi UL, Arguelles AE, Rosner J, De Laborde NP, Cassini JH, Volmer MC: Plasma testosterone and serum lipid in male survivors of myocardial infarction. J Steroid Biochem 1976;7:229–231.
21.
Cauley JA, Gutai JP, Kuller LH, Dai WS: Usefulness of sex steroid hormone levels in predicting coronary artery disease in men. Am J Cardiol 1987;60:771–777.
22.
Slowinska-Srzednicka J, Zglicyzynski S, Ciswicka-Sznajdeman M, Srzednicki M, Soszynski P, Biernacka M, Woroszynska M, Ruzyllo W, Sadowski Z: Decreased plasma dehydroepiandrosterone sulfate and dihydrotestosterone concentrations in young men after myocardial infarction. Atherosclerosis 1989;79:197–203.
23.
Zumoff B, Troxler RG, O’Connor J, Rosenfeld RS, Krean J, Levin J, Hickman JR, Sloan AM, Walker W, Cool RL, Fukushima DK: Abnormal hormone levels in men with coronary artery disease. Arteriosclerosis 1982;2:58–67.
24.
Pivovarov VN, Rossels AN, Kasatkina LV, Kramer A: Hormones in ischemic heart disease with coronary atherosclerosis. Kardiologiia 1978;18:30–36.
25.
Shui-Ping Zhao, Xiang-Ping Li: The association of low plasma testosterone level with coronary artery disease in Chinese men. Intern J Cardiol 1998;63:161–164.
26.
Levin LC, Korenmann SG: Elevated estradiol levels in acute MI and coronary artery disease (abstract). Clin Res 1978;26:308A.
27.
Aksut SV, Aksut G, Karamehmetoglu A, Oram E: The determination of serum estradiol, testosterone and progesterone in acute myocardial infarction. Jpn Heart J 1986;27:825–837.
28.
Woolf PD, Hamill RW, McDonald JV, Lee LA, Kelly M: Transient hypogonadotropic hypogonadism caused by critical illness. J Clin Endocrinol Metab 1985;60:444–450.
29.
Wang C, Chan V, Tse TF, Yeung RTT: Effect of acute myocardial infarction on pituitary-testicular function. Clin Endocrinol 1978;9:249–253.
30.
Kurbanov VA, Nikolaeva LF, Dedov II: Dynamics of pituitary gonadotropin and sex hormone levels in men with myocardial infarction during rehabilitation. Kardiologiia 1986;26:84–87.
31.
Dai WJ, Gutai JP, Kuller LH, LaPorte RE, Falvo-Gerard L, Caggiula A: Relation between plasma high density lipoprotein cholesterol and sex hormone concentrations in men. Am J Cardiol 1984;53:1259–1263.
32.
Gutai J, LaPorte R, Kuller L, Dai W, Falvo-Gerard L, Cagiulla M: Plasma testosterone, high-density lipoprotein cholesterol and other lipoprotein fractions. Am J Cardiol 1981;48:897–902.
33.
Heller RF, Wheeler MJ, Micallef J, Miller NE, Lewis B: Relationship of high density lipoprotein cholesterol with total and free testosterone and sex hormone binding globulin. Acta Endocrinol 1983;104:253–256.
34.
Lindholm J, Winkel P, Brodthagen U, Gyntdberg F: Coronary risk factors and plasma sex hormones. Am J Med 1982;73:648–651.
35.
Nordoy A, Aakvaag A, Thelle D: Sex hormones and high-density lipoproteins in healthy males. Arteriosclerosis. 1979;34:431–436.
36.
Stefanick ML, Williams PT, Krauss RM, Terry RB, Vranizan KM, Wood PD: Relationships of plasma estradiol, testosterone, and sex-hormone-binding globulin with lipoproteins, apolipoproteins, and high density lipoprotein subfractions in men. J Clin Endocrinol Metab 1987;64:723–729.
37.
Semens J, Rouse L, Beilin LJ, Masarei JRJ: Relationship of plasma HDL-cholesterol to testosterone, estradiol, and sex hormone-binding globulin levels in men and women. Metabolism 1983;32:428–432.
© 2000 S. Karger AG, Basel
2000
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.