Published Online
on April 19, 2004

A more recent version of this article appeared on May 4, 2004

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Submitted on June 30, 2003
Revised on December 10, 2003
Accepted on February 4, 2004

Endogenous Sex Hormones and Progression of Carotid Atherosclerosis in Elderly Men

Majon Muller MD, PhD, Annewieke W. van den Beld MD, PhD, Michiel L. Bots MD, PhD, Diederick E. Grobbee MD, PhD, Steven W.J. Lamberts MD, PhD, and Yvonne T. van der Schouw PhD^*

From the Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht (M.M., M.L.B., D.E.G., Y.T.v.d.S.), and Department of Internal Medicine, Erasmus University Medical Center, Rotterdam (A.W.v.d.B., S.W.J.L.), the Netherlands.

^* To whom correspondence should be addressed. E-mail: y.t.vanderschouw{at}umcutrecht.nl.

Background--The burden of atherosclerosis especially afflicts the increasing older segment of the population. Recent evidence has emphasized a protective role of endogenous sex hormones in the development of atherosclerosis in aging men.

Methods and Results--We studied the association between endogenous sex hormones and progression of atherosclerosis in 195 independently living elderly men. Participants underwent measurements of carotid intima-media thickness (IMT) at baseline in 1996 and again in 2000. At baseline, serum concentrations of testosterone (total and free) and estradiol (total and free E₂) were measured. Serum free testosterone concentrations were inversely related to the mean progression of IMT of the common carotid artery after adjustment for age (=-3.57; 95% CI, -6.34 to -0.80). Higher serum total and free E₂ levels were related to progression of IMT of the common carotid artery after adjustment for age (=0.38; 95% CI, -0.11 to 0.86; and =0.018; 95% CI, -0.002 to 0.038, respectively). These associations were independent of body mass index, waist-to-hip ratio, presence of hypertension and diabetes, smoking, and serum cholesterol levels

Conclusions--Low free testosterone levels were related to IMT of the common carotid artery in elderly men independently of cardiovascular risk factors.

Key words: atherosclerosis • carotid arteries • hormones • men

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