Abstract
Objectives
Men show higher rates of cardiovascular morbidity and mortality than pre-menopausal
women and this sexual dimorphism may be related to sex-specific effects of sex steroids
on cardiovascular risk factors. Unlike androgens, estrogens were not extensively investigated
in relation to cardiovascular phenotypes in men.
Methods
We examined associations of estradiol and estrone and their precursors (total testosterone
and androstenedione) with traditional cardiovascular risk factors (lipids, blood pressure,
body mass) in 933 young (median age: 19 years), apparently healthy Polish men.
Results
Total estradiol was associated with total cholesterol (p = 0.006) and high-density lipoprotein cholesterol (HDL-C) (p < 0.001) and estrone showed the strongest associations with both total cholesterol (p < 0.001) and low-density lipoprotein cholesterol (LDL-C) (p < 0.001) in the unadjusted ANOVA analysis. In the multivariable adjusted models in which
other independent variables were held as constant one standard deviation increase
in estradiol level was associated with 6%-standard deviation increase in total cholesterol
(standardized β = 0.06, p = 0.038) and 6%-standard deviation decrease in HDL-cholesterol (standardized β = −0.06, p = 0.036). An increase in estrone levels by one standard deviation was associated with
respective 12%- and 13%-standard deviation increases in total cholesterol (standardized
β = 0.12, p < 0.001) and LDL-cholesterol levels (standardized β = 0.12, p < 0.001) after controlling for other predictors of lipids. Estrone correlated linearly
with androstenedione (r = 0.28, p < 0.001) but there was no correlation between estradiol and testosterone. Estrogens
retained their independent associations with lipids after adjustment for their biochemical
precursors in the multivariable analysis.
Conclusions
Increased levels of estrogens are associated with unfavourable lipid profile in men
and this association is present early in life, before apparent manifestations of cardiovascular
disease.
Keywords
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Article info
Publication history
Published online: July 21, 2008
Accepted:
June 5,
2008
Received in revised form:
May 14,
2008
Received:
April 5,
2008
Identification
Copyright
© 2008 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
