Sex steroids and cardiovascular disease Yeap BB - Asian J Androl - 0 views
www.ajandrology.com/article.asp
cardiovascular disease CVD sex estradiol carotid intima-media thickness hormones hormone men Testosterone estrogen
shared by Nathan Goodyear on 15 Jan 14
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Levels of SHBG are higher in older men, therefore levels of free T decline more steeply than total T as men's age increases.
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calculations based on mass action equations may not reflect precisely free T measured using a reference method
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free T declines more steeply with age than total T in both cross-sectional [35] and longitudinal studies, [36] as does free E2 in comparison to total E2
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T may slow development of or progression of atherosclerosis by modulating effects on insulin resistance, inflammation, endothelial function, preclinical atherosclerosis or the vasculature.
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these cross-sectional and longitudinal studies support a relationship between low circulating T with CIMT and higher E2 with its progression
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low levels of total or bioavailable T were associated with aortic atherosclerosis manifested as calcified deposits detected by radiography
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Men with total or free T in the lowest quartile had increased adjusted ORs for PAD defined as ABI <0.90, as did men with free E2 in the highest quartile of values
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The apparent association of SHBG with intermittent claudication reflects the correlation of total T with SHBG, while the contribution of E2 to risk of PAD remains unclear
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men with total T in the lowest quartile of values (<11.7 nmol l−1 ) experienced an increased incidence of stroke or transient ischemic attack
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cohort studies in mostly older men have supported the association of lower androgen levels with higher mortality
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lower total or free T levels were associated with mortality in older men, but with discordant results for cause-specific mortality and for associations of E2
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several large studies identifying lower endogenous levels of total or free T as independent predictors of all-cause or CVD-related deaths in middle-aged and older men
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T exhibits anti-inflammatory effects, enhances flow-mediated brachial artery reactivity, and reduces arterial stiffness
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Short-term T therapy had a beneficial effect on exercise-induced myocardial ischemia in middle-aged men with coronary artery disease or chronic stable angina, [95],[96],[97] and reduced angina frequency in older men with diabetes and coronary artery disease
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there are interventional studies supporting a protective effect of exogenous T against myocardial ischemia in men with coronary artery disease
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Observational studies indicate that lower levels of endogenous T in older men are associated with the presence of carotid atherosclerosis, aortic and peripheral vascular disease, and incidence of CVD events and mortality
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Interventional studies have shown beneficial effects of exogenous T on vascular function and on exercise-induced myocardial ischemia in men with coronary artery disease
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