Author + information
- Received August 26, 2004
- Revision received December 22, 2004
- Accepted January 11, 2005
- Published online May 17, 2005.
- Juuso Mäkinen, MD⁎,†,
- Mikko J. Järvisalo, MD, PhD⁎,†,‡,††,
- Pasi Pöllänen, MD, PhD§∥,
- Antti Perheentupa, MD, PhD§,#,
- Kerttu Irjala, MD, PhD¶,
- Markku Koskenvuo, MD, PhD⁎⁎,
- Juha Mäkinen, MD, PhD§,
- Ilpo Huhtaniemi, MD, PhD#,‡‡ and
- Olli T. Raitakari, MD, PhD†,‡,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Olli T. Raitakari, Turku PET Centre, Kiinamyllynkatu 4-8, FIN-20500 Turku, Finland
Objectives This study examined the association between carotid artery intima-media thickness (IMT), serum sex hormone levels, and andropausal symptoms in middle-aged men.
Background Male sex hormones may play a dual role in the pathogenesis of atherosclerosis in men by carrying both proatherogenic and atheroprotective effects.
Methods We studied 239 40- to 70-year-old men (mean ± SD: 57 ± 8 years) who participated in the Turku Aging Male Study and underwent serum lipid and sex hormone measurements. Ninety-nine men (age 58 ± 7 years) were considered andropausal (i.e., serum testosterone <9.8 nmol/l or luteinizing hormone [LH] >6.0 U/l and testosterone in the normal range), and in both situations, they had subjective symptoms of andropause (a high symptom score in questionnaire). Three were excluded because of diabetes. The rest of the men (age 57 ± 8 years) served as controls. Carotid IMT was determined using high-resolution B-mode ultrasound, and serum testosterone, estradiol (E2), LH, and sex hormone-binding globulin were measured using standard immunoassays.
Results Andropausal men had a higher maximal IMT compared with controls in the common carotid (1.08 ± 0.34 vs. 1.00 ± 0.23, p < 0.05) and in the carotid bulb (1.44 ± 0.48 vs. 1.27 ± 0.35, p = 0.003). Common carotid IMT correlated inversely with serum testosterone (p = 0.003) and directly with LH (p = 0.006) in multivariate models adjusted for age, total cholesterol, body mass index, blood pressure, and smoking.
Conclusions Middle-aged men with symptoms of andropause, together with absolute or compensated (as reflected by high normal to elevated LH) testosterone deficiency, show increased carotid IMT. These data suggest that normal testosterone levels may offer protection against the development of atherosclerosis in middle-aged men.
The first two authors contributed equally. This study was financially supported by the Emil Aaltonen Foundation, the Finnish Foundation for Cardiovascular Research, the Finnish Medical Society Duodecim in Turku, and the Academy of Finland (grants 201 888, 74 092, and 869 864). JenaPharm GmbH, Jena, Germany, is acknowledged for collaboration.
- Received August 26, 2004.
- Revision received December 22, 2004.
- Accepted January 11, 2005.
- American College of Cardiology Foundation