Low testosterone levels are associated with carotid atherosclerosis in men

Abstract

Objective. To study the relationship between endogenous sex hormone levels and intima-media thickness (IMT) of the carotid artery measured by ultrasonography. Design. Population-based cross-sectional study. Methods. Sex hormone levels measured by immunoassay, anthropometric measurements and IMT was studied in 1482 men aged 25-84 years participating in the 1994-1995 Tromsø study. The data were analysed with partial correlation, multiple linear regression and logistic regression analysis. Results. Linear regression models showed that total testosterone and sex hormone-binding globulin levels, but not calculated free testosterone, serum oestradiol or dehydroepiandrosterone sulphate levels were inversely associated with the age-adjusted IMT (P ¼ 0.008 and P < 0.001 respectively). These associations were independent of smoking, physical activity, blood pressure and lipid levels, but were not independent of body mass index (BMI). Excluding men with cardiovascular disease (CVD) did not materially change these results. In a logistic regression model adjusted for the confounding effect of CVD risk factors, men with testosterone levels in the lowest quintile (<9.0 nmol L )1 ) had an independent OR ¼ 1.51 (P ¼ 0.015) of being in the highest IMT quintile. Conclusions. We found an inverse association between total testosterone levels and IMT of the carotid artery in men that was present also after excluding men with CVD, but was not independent of BMI. The clinical relevance of this, however, is uncertain and needs to be investigated in a clinical setting.

Testosterone: a vascular hormone in health and disease

“…Intima-media thickness (IMT, a measure of the thickness of the innermost two layers of the arterial wall) is associated with atherosclerosis and is viewed as a surrogate endpoint for evaluating the regression and/or progression of atherosclerotic CVD. Several human studies have shown that carotid IMT (CIMT) and aortic calcification negatively correlate with serum testosterone (Hak et al 2002, van den Beld et al 2003, Fukui et al 2003, Muller et al 2004, Demirbag et al 2005, Mäkinen et al 2005, Svartberg et al 2006. Low levels of testosterone in men were inversely related to the mean progression of IMT in the common carotid artery even after adjusting for age, and this relationship was found to be independent of other cardiovascular risk factors (Muller et al 2004).…”

Roles of the Androgen – Androgen Receptor System in Vascular Angiogenesis

“…In addition, low levels of androgens in men have been shown to be important risk factors for the development of the intima-media thickening in the common carotid artery even after adjusting for age, sex, and other cardiovascular risk factors 47,48) . Several human studies have also shown that the severity of aortic calcification negatively correlates with the testosterone serum level 47,[49][50][51][52][53] . Moreover, physiological concentrations of testosterone have been shown to maintain homeostasis of the hemostatic system through the enhancement of anticoagulant activity and antithrombotic effects [54][55][56] .…”

Effects of Intramuscular or Bioadhesive Buccal Testosterone Treatment on Antioxidant Systems in Secondary Hypogonadism

“…Low testosterone levels may predict increased cardiovascular risk in men [13]. Moreover, treatment with exogenous testosterone improved arterial vasodilation [14] and lipid profile [15] in patients with cardiovascular disease.…”