The Relationship Between Inflammation and Serum Estrogen, Testosterone, and DHEA-S Levels in Obstructive Coronary Artery Disease
AbstractObjectives: The relationship between sex hormones (estrogen, testosterone) and coronary artery disease (CAD) has been found to be controversial in various studies. Moreover, recent studies revealed an association between CAD and DHEA-S (dehydroepiandrosterone sulphate) which is an endogenous steroid hormone and the precursor of sex hormones. We aimed to investigate (1) the relationship between serum testosterone, estrogen, DHEA levels and obstructive coronary artery disease (OCAD), (2) also to assess how this relation is effected by C-reactive protein (CRP) in patients who have possible stable CAD. Study Design: A hundred patients enrolled in the study. Patients were assigned to two groups based on the presence of lesions that causes luminal narrowing more than % 50 in at least one epicardial coronary artery (OCAD, N-OCAD). Serum total testosterone, estrogen, DHEA-S and CRP levels were studied in both groups. Results: OCAD was detected in 75 (60 m, 15 f) patients. The mean age was 60.1 ± 14.2 in the OCAD group and 59.2 ± 11.2 in the N-OCAD group. Serum/plasma HbA1c levels and having male gender were significantly higher in the OCAD group. (p = 0.002, p = 0.008). Serum sex hormones were shown to have no significant differences between groups. However, there was a poor correlation between DHEA-S and CRP levels in the OCAD group. Conclusion: Our data showed that there is no significant relationship between serum sex hormone levels and OCAD. However, we found a weak correlation between DHEA-S and the CRP.
Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. The lancet. 1997;349(9063):1436-1442.
Malkin C, Pugh P, Jones R, Jones T, Channer K. Testosterone as a protective factor against atherosclerosis--immunomodulation and influence upon plaque development and stability. Journal of Endocrinology. 2003;178(3):373-380.
Morris PD, Channer KS. Testosterone and cardiovascular disease in men. Asian journal of andrology. 2012;14(3):428-435.
Wranicz JK, Cygankiewicz I, Kula P, Walczak-Jedrzejowska R, Slowikowska-Hilczer J, Kula K. Endogenous estradiol and testosterone may predispose toward atherogenic lipid profile, but higher blood level of testosterone is associated with lower number of stenoses in the coronary arteries of men with coronary disease. International journal of biomedical science: IJBS. 2006;2(2):135.
ONAT A, UYAREL H, TÜRKMEN S, et al. Serum Total Testosterone Levels and Coronary Disease Risk in Postmenopausal Turkish Women. Archives of the Turkish Society of Cardiology. 2004;32(3):137-144.
Collins P, Shay J, Jiang C, Moss J. Nitric oxide accounts for dose-dependent estrogen-mediated coronary relaxation after acute estrogen withdrawal. Circulation. 1994;90(4):1964-1968.
Wranicz JK, Cygankiewicz I, Rosiak M, Kula P, Kula K, Zareba W. The relationship between sex hormones and lipid profile in men with coronary artery disease. International journal of cardiology. 2005;101(1):105-110.
Tomaszewski M, Charchar FJ, Maric C, et al. Association between lipid profile and circulating concentrations of estrogens in young men. Atherosclerosis. 2009;203(1):257-262.
Yarnell J, Beswick A, Sweetnam P, Riad-Fahmy D. Endogenous sex hormones and ischemic heart disease in men. The Caerphilly prospective study. Arteriosclerosis, Thrombosis, and Vascular Biology. 1993;13(4):517-520.
Guo C, Zhang S, Zhang J, et al. Correlation between the severity of coronary artery lesions and levels of estrogen, hs-CRP and MMP-9. Experimental and therapeutic medicine. 2014;7(5):1177-1180.
He H, Yang F, Liu X, et al. Sex hormone ratio changes in men and postmenopausal women with coronary artery disease. Menopause. 2007;14(3):385-390.
Rohrmann S, Platz EA, Selvin E, et al. The prevalence of low sex steroid hormone concentrations in men in the Third National Health and Nutrition Examination Survey (NHANES III). Clinical endocrinology. 2011;75(2):232-239.
Allameh F, Pourmand G, Bozorgi A, Nekuie S, Namdari F. The Association between Androgenic Hormone Levels and the Risk of Developing Coronary Artery Disease (CAD). Iranian journal of public health. 2016;45(1):14-19.
Hayashi T, Fukuto JM, Ignarro LJ, Chaudhuri G. Basal release of nitric oxide from aortic rings is greater in female rabbits than in male rabbits: implications for atherosclerosis. Proceedings of the National Academy of Sciences. 1992;89(23):11259-11263.
Merz CNB, Johnson BD, Berga SL, et al. Total estrogen time and obstructive coronary disease in women: insights from the NHLBI-sponsored Women's Ischemia Syndrome Evaluation (WISE). Journal of Women's Health. 2009;18(9):1315-1322.
Akishita M, Hashimoto M, Ohike Y, et al. Association of plasma dehydroepiandrosterone-sulfate levels with endothelial function in postmenopausal women with coronary risk factors. Hypertension Research. 2008;31(1):69-74.