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Uçar A. Challenges in the Cross-Sectional Assessment of Cardiovascular Risk in Children with Premature Adrenarche due to the Multifaceted Nature of Atherosclerosis
. Horm Res Paediatr 2019; 87:143-144. [PMID: 28166531 DOI: 10.1159/000455851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 01/05/2017] [Indexed: 11/19/2022] Open
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Wu T, Gao Y, Zheng Y, Ma Y, Xie X. Association of endogenous
DHEA
/
DHEAS
with coronary heart disease: A systematic review and meta‐analysis. Clin Exp Pharmacol Physiol 2019; 46:984-994. [PMID: 31347187 DOI: 10.1111/1440-1681.13146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 07/17/2019] [Accepted: 07/19/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Ting‐Ting Wu
- Department of Cardiology First Affiliated Hospital of Xinjiang Medical University Urumqi China
- Xinjiang Key Laboratory of Cardiovascular Disease Research Urumqi China
| | - Ying Gao
- Cadre Ward First Affiliated Hospital of Xinjiang Medical University Urumqi China
| | - Ying‐Ying Zheng
- Department of Cardiology First Affiliated Hospital of Zhengzhou University Zhengzhou China
| | - Yi‐Tong Ma
- Department of Cardiology First Affiliated Hospital of Xinjiang Medical University Urumqi China
- Xinjiang Key Laboratory of Cardiovascular Disease Research Urumqi China
| | - Xiang Xie
- Department of Cardiology First Affiliated Hospital of Xinjiang Medical University Urumqi China
- Xinjiang Key Laboratory of Cardiovascular Disease Research Urumqi China
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Bentley C, Hazeldine J, Greig C, Lord J, Foster M. Dehydroepiandrosterone: a potential therapeutic agent in the treatment and rehabilitation of the traumatically injured patient. BURNS & TRAUMA 2019; 7:26. [PMID: 31388512 PMCID: PMC6676517 DOI: 10.1186/s41038-019-0158-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 05/03/2019] [Indexed: 02/07/2023]
Abstract
Severe injuries are the major cause of death in those aged under 40, mainly due to road traffic collisions. Endocrine, metabolic and immune pathways respond to limit the tissue damage sustained and initiate wound healing, repair and regeneration mechanisms. However, depending on age and sex, the response to injury and patient prognosis differ significantly. Glucocorticoids are catabolic and immunosuppressive and are produced as part of the stress response to injury leading to an intra-adrenal shift in steroid biosynthesis at the expense of the anabolic and immune enhancing steroid hormone dehydroepiandrosterone (DHEA) and its sulphated metabolite dehydroepiandrosterone sulphate (DHEAS). The balance of these steroids after injury appears to influence outcomes in injured humans, with high cortisol: DHEAS ratio associated with increased morbidity and mortality. Animal models of trauma, sepsis, wound healing, neuroprotection and burns have all shown a reduction in pro-inflammatory cytokines, improved survival and increased resistance to pathological challenges with DHEA supplementation. Human supplementation studies, which have focused on post-menopausal females, older adults, or adrenal insufficiency have shown that restoring the cortisol: DHEAS ratio improves wound healing, mood, bone remodelling and psychological well-being. Currently, there are no DHEA or DHEAS supplementation studies in trauma patients, but we review here the evidence for this potential therapeutic agent in the treatment and rehabilitation of the severely injured patient.
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Affiliation(s)
- Conor Bentley
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospital Birmingham, Birmingham, B15 2WB UK
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, Birmingham University Medical School, Birmingham, B15 2TT UK
| | - Jon Hazeldine
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospital Birmingham, Birmingham, B15 2WB UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, Birmingham University Medical School, Birmingham, B15 2TT UK
| | - Carolyn Greig
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
- NIHR Biomedical Research Centre, University Hospital Birmingham, Birmingham, UK
| | - Janet Lord
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospital Birmingham, Birmingham, B15 2WB UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, Birmingham University Medical School, Birmingham, B15 2TT UK
- NIHR Biomedical Research Centre, University Hospital Birmingham, Birmingham, UK
| | - Mark Foster
- NIHR Surgical Reconstruction and Microbiology Research Centre, University Hospital Birmingham, Birmingham, B15 2WB UK
- Royal Centre for Defence Medicine, Birmingham Research Park, Birmingham, B15 2SQ UK
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Basson R, O'Loughlin JI, Weinberg J, Young AH, Bodnar T, Brotto LA. Dehydroepiandrosterone and cortisol as markers of HPA axis dysregulation in women with low sexual desire. Psychoneuroendocrinology 2019; 104:259-268. [PMID: 30909007 PMCID: PMC7343293 DOI: 10.1016/j.psyneuen.2019.03.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 01/15/2019] [Accepted: 03/04/2019] [Indexed: 11/30/2022]
Abstract
Previous research has found lower serum levels of dehydroepiandrosterone (DHEA) or its sulfated form, DHEA-S, in women diagnosed with Hypoactive Sexual Desire Disorder (HSDD). Given that DHEA and DHEA-S have multiple direct actions on the brain as well as anti-glucocorticoid properties, it is possible that lower levels of DHEA directly impact women's sexual functioning. To date, the significance of the lower DHEA levels remains unclear. To our knowledge, there has been no empirical study of stress hormones as markers of HPA dysregulation in women with HSDD. To attend to this gap, the present study utilized several measures of HPA axis function - morning and evening cortisol and DHEA, the cortisol awakening response (CAR), diurnal cortisol slope, and cortisol:DHEA ratio - and examined their relationship with sexual functioning in N = 275 women with (n = 137) and without (n = 138) HSDD. Results demonstrated multiple hormonal markers of HPA dysregulation in women diagnosed with HSDD compared to control participants, specifically, lower AM cortisol and AM DHEA levels, a flatter diurnal cortisol slope, and a lower CAR. Overall, results of the present study indicate that persistently low sexual desire in women is associated with HPA axis dysregulation, with both cortisol and DHEA alterations potentially detrimental to sexual desire.
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Affiliation(s)
- Rosemary Basson
- University of British Columbia, Department of Psychiatry, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Julia I O'Loughlin
- University of British Columbia, Department of Counselling Psychology, 2125 Main Mall, Vancouver, BC V6T 1Z4, Canada
| | - Joanne Weinberg
- University of British Columbia, Department of Cellular & Physiological Sciences, 2350 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada
| | - Allan H Young
- King's College London, Centre for Affective Disorders, Department of Psychological Medicine, PO72, De Crespigny Park, Denmark Hill, London, SE5 8AF, Canada
| | - Tamara Bodnar
- University of British Columbia, Department of Cellular & Physiological Sciences, 2350 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada
| | - Lori A Brotto
- University of British Columbia, Department of Obstetrics and Gynaecology, 2775 Laurel Street, 6(th) Floor, Vancouver, BC V5Z 1M9, Canada.
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Chae HS, You BH, Kim DY, Lee H, Ko HW, Ko HJ, Choi YH, Choi SS, Chin YW. Sauchinone controls hepatic cholesterol homeostasis by the negative regulation of PCSK9 transcriptional network. Sci Rep 2018; 8:6737. [PMID: 29712938 PMCID: PMC5928089 DOI: 10.1038/s41598-018-24935-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 04/12/2018] [Indexed: 12/15/2022] Open
Abstract
Whole-transcriptome analysis and western blotting of sauchinone-treated HepG2 cells demonstrated that sauchinone regulated genes relevant to cholesterol metabolism and synthesis. In particular, it was found that the expression of proprotein convertase subtilisin/kexin type 9 (PCSK9) was downregulated, and the expression of low density lipoprotein receptor (LDLR) was upregulated in sauchinone-treated HepG2 cells. Consequently, LDL-cholesterol (LDL-C) uptake was increased. As a transcriptional regulator of PCSK9 expression, sterol regulatory elements binding protein-2 (SREBP-2) was proposed by transcriptome analysis and western blotting. Oral administration of sauchinone increased hepatic LDLR through PCSK9 inhibition in obese mice and showed the reduced serum LDL-C levels and downstream targets of SREBP-2. Thus, it is evident that sauchinone reduces hepatic steatosis by downregulating the expression of hepatic PCSK9 via SREBP-2.
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Affiliation(s)
- Hee-Sung Chae
- College of Pharmacy and Integrated Research Institute for Drug Development, Dongguk University-Seoul, Goyang, Gyeonggi-do, 10326, Republic of Korea
| | - Byoung Hoon You
- College of Pharmacy and Integrated Research Institute for Drug Development, Dongguk University-Seoul, Goyang, Gyeonggi-do, 10326, Republic of Korea
| | - Dong-Yeop Kim
- Division of Biomedical Convergence, College of Biomedical Science, and Institute of Bioscience & Biotechnology, Kangwon National University, Chuncheon, Gangwon, 24341, Republic of Korea
| | - Hankyu Lee
- College of Pharmacy and Integrated Research Institute for Drug Development, Dongguk University-Seoul, Goyang, Gyeonggi-do, 10326, Republic of Korea
| | - Hyuk Wan Ko
- College of Pharmacy and Integrated Research Institute for Drug Development, Dongguk University-Seoul, Goyang, Gyeonggi-do, 10326, Republic of Korea
| | - Hyun-Jeong Ko
- Laboratory of Microbiology and Immunology, College of Pharmacy, Kangwon National University, Chuncheon, Gangwon, 24341, Republic of Korea
| | - Young Hee Choi
- College of Pharmacy and Integrated Research Institute for Drug Development, Dongguk University-Seoul, Goyang, Gyeonggi-do, 10326, Republic of Korea
| | - Sun Shim Choi
- Division of Biomedical Convergence, College of Biomedical Science, and Institute of Bioscience & Biotechnology, Kangwon National University, Chuncheon, Gangwon, 24341, Republic of Korea
| | - Young-Won Chin
- College of Pharmacy and Integrated Research Institute for Drug Development, Dongguk University-Seoul, Goyang, Gyeonggi-do, 10326, Republic of Korea.
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Simitsidellis I, Saunders PTK, Gibson DA. Androgens and endometrium: New insights and new targets. Mol Cell Endocrinol 2018; 465:48-60. [PMID: 28919297 DOI: 10.1016/j.mce.2017.09.022] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 09/08/2017] [Accepted: 09/14/2017] [Indexed: 12/21/2022]
Abstract
Androgens are synthesised in both the ovary and adrenals in women and play an important role in the regulation of female fertility, as well as in the aetiology of disorders such as polycystic ovarian syndrome, endometriosis and endometrial cancer. The endometrium is an androgen target tissue and the impact of AR-mediated effects has been studied using human endometrial tissue samples and rodent models. In this review we highlight recent evidence that endometrial androgen biosynthesis and intracrine action is important in preparation of a tissue microenvironment that can support implantation and establishment of pregnancy. The impact of androgens on endometrial cell proliferation, in repair of the endometrial wound at the time of menstruation and in endometrial disorders is discussed. Future directions for research focused on AR function as a therapeutic target are considered.
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Affiliation(s)
- Ioannis Simitsidellis
- Medical Research Council Centre for Inflammation Research, The University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Philippa T K Saunders
- Medical Research Council Centre for Inflammation Research, The University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Douglas A Gibson
- Medical Research Council Centre for Inflammation Research, The University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK.
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Watts EL, Appleby PN, Albanes D, Black A, Chan JM, Chen C, Cirillo PM, Cohn BA, Cook MB, Donovan JL, Ferrucci L, Garland CF, Giles GG, Goodman PJ, Habel LA, Haiman CA, Holly JMP, Hoover RN, Kaaks R, Knekt P, Kolonel LN, Kubo T, Le Marchand L, Luostarinen T, MacInnis RJ, Mäenpää HO, Männistö S, Metter EJ, Milne RL, Nomura AMY, Oliver SE, Parsons JK, Peeters PH, Platz EA, Riboli E, Ricceri F, Rinaldi S, Rissanen H, Sawada N, Schaefer CA, Schenk JM, Stanczyk FZ, Stampfer M, Stattin P, Stenman UH, Tjønneland A, Trichopoulou A, Thompson IM, Tsugane S, Vatten L, Whittemore AS, Ziegler RG, Allen NE, Key TJ, Travis RC. Circulating sex hormones in relation to anthropometric, sociodemographic and behavioural factors in an international dataset of 12,300 men. PLoS One 2017; 12:e0187741. [PMID: 29281666 PMCID: PMC5744924 DOI: 10.1371/journal.pone.0187741] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 10/25/2017] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Sex hormones have been implicated in the etiology of a number of diseases. To better understand disease etiology and the mechanisms of disease-risk factor associations, this analysis aimed to investigate the associations of anthropometric, sociodemographic and behavioural factors with a range of circulating sex hormones and sex hormone-binding globulin. METHODS Statistical analyses of individual participant data from 12,330 male controls aged 25-85 years from 25 studies involved in the Endogenous Hormones Nutritional Biomarkers and Prostate Cancer Collaborative Group. Analysis of variance was used to estimate geometric means adjusted for study and relevant covariates. RESULTS Older age was associated with higher concentrations of sex hormone-binding globulin and dihydrotestosterone and lower concentrations of dehydroepiandrosterone sulfate, free testosterone, androstenedione, androstanediol glucuronide and free estradiol. Higher body mass index was associated with higher concentrations of free estradiol, androstanediol glucuronide, estradiol and estrone and lower concentrations of dihydrotestosterone, testosterone, sex hormone-binding globulin, free testosterone, androstenedione and dehydroepiandrosterone sulfate. Taller height was associated with lower concentrations of androstenedione, testosterone, free testosterone and sex hormone-binding globulin and higher concentrations of androstanediol glucuronide. Current smoking was associated with higher concentrations of androstenedione, sex hormone-binding globulin and testosterone. Alcohol consumption was associated with higher concentrations of dehydroepiandrosterone sulfate, androstenedione and androstanediol glucuronide. East Asians had lower concentrations of androstanediol glucuronide and African Americans had higher concentrations of estrogens. Education and marital status were modestly associated with a small number of hormones. CONCLUSION Circulating sex hormones in men are strongly associated with age and body mass index, and to a lesser extent with smoking status and alcohol consumption.
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Affiliation(s)
- Eleanor L. Watts
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Paul N. Appleby
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, MD, United States of America
| | - Amanda Black
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, MD, United States of America
| | - June M. Chan
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA, United States of America
- Department of Urology, University of California-San Francisco, San Francisco, CA, United States of America
| | - Chu Chen
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Piera M. Cirillo
- Child Health and Development Studies, Public Health Institute, Berkeley, CA, United States of America
| | - Barbara A. Cohn
- Child Health and Development Studies, Public Health Institute, Berkeley, CA, United States of America
| | - Michael B. Cook
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, MD, United States of America
| | - Jenny L. Donovan
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Bethesda, MD, United States of America
| | - Cedric F. Garland
- Department of Family Medicine and Public Health, University of California, San Diego, CA, United States of America
| | - Graham G. Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Phyllis J. Goodman
- SWOG Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Laurel A. Habel
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Christopher A. Haiman
- Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Jeff M. P. Holly
- School of Clinical Sciences, Faculty of Health Science, University of Bristol, Bristol, United Kingdom
| | - Robert N. Hoover
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, MD, United States of America
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany
| | - Paul Knekt
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Laurence N. Kolonel
- University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI, United States of America
| | - Tatsuhiko Kubo
- Department of Public Health, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Loïc Le Marchand
- University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI, United States of America
| | - Tapio Luostarinen
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Robert J. MacInnis
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Hanna O. Mäenpää
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
| | - Satu Männistö
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - E. Jeffrey Metter
- Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States of America
| | - Roger L. Milne
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Abraham M. Y. Nomura
- Japan-Hawaii Cancer Study, Kuakini Medical Center, Honolulu, HI, United States of America
| | - Steven E. Oliver
- Department of Health Sciences, University of York, York, United Kingdom
| | - J. Kellogg Parsons
- Division of Urologic Oncology, University of California San Diego Moores Cancer Center, San Diego, CA, United States of America
| | - Petra H. Peeters
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands
- MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London, United Kingdom
| | - Elizabeth A. Platz
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Elio Riboli
- School of Public Health, Imperial College London, London, United Kingdom
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Grugliasco, Italy
| | - Sabina Rinaldi
- Biomarkers Group, International Agency for Research on Cancer, Lyon, France
| | - Harri Rissanen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Catherine A. Schaefer
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America
| | - Jeannette M. Schenk
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, United States of America
| | - Frank Z. Stanczyk
- Division of Reproductive Endocrinology and Infertility, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States of America
| | - Meir Stampfer
- Departments of Nutrition and Epidemiology, Harvard University T.H. Chan School of Public Health, Boston, MA, United States of America
- The Channing Division of Network Medicine, Harvard Medical School, Boston, MA, United States of America
| | - Pär Stattin
- Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden
| | - Ulf-Håkan Stenman
- Department of Clinical Chemistry, Medicum, University of Helsinki, Helsinki, Finland
| | - Anne Tjønneland
- Department of Diet, Genes and Environment, The Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Antonia Trichopoulou
- Hellenic Health Foundation, Athens, Greece
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Ian M. Thompson
- CHRISTUS Medical Center Hospital, San Antonio, TX, United States of America
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Lars Vatten
- Department of Public Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Alice S. Whittemore
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, United States of America
- Department of Biomedical Data Science, Stanford University, Stanford, CA, United States of America
| | - Regina G. Ziegler
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, MD, United States of America
| | - Naomi E. Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Timothy J. Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Ruth C. Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Martin YN, Pabelick CM. Sex differences in the pulmonary circulation: implications for pulmonary hypertension. Am J Physiol Heart Circ Physiol 2014; 306:H1253-64. [PMID: 24610923 DOI: 10.1152/ajpheart.00857.2013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Pulmonary arterial hypertension (PAH), a form of pulmonary hypertension, is a complex disease of multifactorial origin. While new developments regarding pathophysiological features and therapeutic options in PAH are being reported, one important fact has emerged over the years: there is a sex difference in the incidence of this disease such that while there is a higher incidence in females, disease outcomes are much worse in males. Accordingly, recent attention has been focused on understanding the features of sex differences in the pulmonary circulation and the contributory mechanisms, particularly sex hormones and their role in the pathological and pathophysiological features of PAH. However, to date, there is no clear consensus whether sex hormones (particularly female sex steroids) are beneficial or detrimental in PAH. In this review, we highlight some of the most recent evidence regarding the influence of sex hormones (estrogen, testosterone, progesterone, dehydroepiandrosterone) and estrogen metabolites on key pathophysiological features of PAH such as proliferation, vascular remodeling, vasodilation/constriction, and inflammation, thus setting the stage for research avenues to identify novel therapeutic target for PAH as well as potentially other forms of pulmonary hypertension.
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Affiliation(s)
- Yvette N Martin
- Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota; and
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Chen J, Xu L, Huang C. DHEA inhibits vascular remodeling following arterial injury: a possible role in suppression of inflammation and oxidative stress derived from vascular smooth muscle cells. Mol Cell Biochem 2013; 388:75-84. [PMID: 24287563 DOI: 10.1007/s11010-013-1900-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Accepted: 11/15/2013] [Indexed: 12/01/2022]
Abstract
Vascular remodeling is characterized by the aggregation of vascular smooth muscle cells (VSMCs) in intima. Previous studies have demonstrated that dehydroepiandrosterone (DHEA), a steroid hormone, can reverse vascular remodeling. However, it is still far clear that whether and how DHEA participates in the modulation of VSMCs activation and vascular remodeling. VSMCs were obtained from the thoracic aorta of SD rats. Cell proliferation was evaluated by CCK-8 assay and BrdU assay. To measure VSMCs migration activity, a transwell chamber assay was performed. Quantitative real-time RT-PCR and western blot were used to explore the molecular mechanisms. ROS generation by VSMCs was measured by DCF fluorescence. NADPH oxidase activity and SOD activity were measured by the corresponding kits. NF-κB activity was detected by NF-κB luciferase reporter gene assay. A rat carotid artery balloon injury model was built to evaluate the neointimal formation, and plasma PGF2 was measured by ELISA. Our results showed that DHEA significantly inhibited VSMCs proliferation after angiotensin (Ang II) stimulation by down-regulation of NADPH oxidase activity and ERK1/2 phosphorylation. Ang II can increase IL-6 and MCP-1 expression, but DHEA reverses these changes via inhibiting p38-MAPK/NF-κB (p65) signaling pathway. DHEA has no significant effects on VSMCs phenotype transition, but can reduce the neointimal to media area ratio after balloon injury. DHEA can alleviate oxidative stress and inflammation in VSMCs via ERK1/2 and NF-κB signaling pathway, but has no effect on VSMCs phenotype transition. Furthermore, DHEA attenuates VSMCs activation and neointimal formation after carotid injury in vivo. Taken together, DHEA might be a promising treatment for vascular injury under pathological condition.
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Affiliation(s)
- Jiangbin Chen
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, People's Republic of China
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Uçar A, Saka N, Baş F, Hatipoğlu N, Bundak R, Darendeliler F. Reduced atherogenic indices in prepubertal girls with precocious adrenarche born appropriate for gestational age in relation to the conundrum of DHEAS. Endocr Connect 2013; 2:1-10. [PMID: 23781312 PMCID: PMC3680958 DOI: 10.1530/ec-12-0059] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 10/04/2012] [Indexed: 01/26/2023]
Abstract
CONTEXT An association between low birth weight, insulin resistance (IR), dyslipidemia, and atherogenesis has been shown in girls with precocious adrenarche (PA). OBJECTIVE To evaluate whether girls with PA born appropriate for gestational age (AGA) have increased risk for metabolic complications at initial evaluation. DESIGN/METHODS We conducted a cross-sectional study on 69 AGA born girls with PA (mean (±s.d.) age 7.1±1 years) and 45 body mass index (BMI)- and waist circumference (WC)-matched prepubertal peers born AGA (mean (±s.d.) 7.5±1.9 years). A standard 2-h oral glucose tolerance test with insulin sampling was performed. Fasting plasma lipids and high-sensitivity C-reactive protein were analyzed, and blood pressure was recorded. Insulin sensitivity (IS) index (ISIcomp), homeostasis model assessment of IR, and atherogenic index (AI) (triglycerides/high-density lipoprotein cholesterol) were calculated. SETTING The study was performed at University Hospital. RESULTS AI was significantly lower in girls with PA than in controls (P<0.001), and it was correlated with BMI SDS (r=0.44, P=0.001) and WC (r=0.39, P=0.001). The significant correlation of AI with ISIcomp (r=-0.38, P=0.001) disappeared after correcting for BMI (r=-0.185, P=0.16). Multivariate regression analysis revealed that DHEAS was the only significant parameter influencing AI in girls with born AGA (R (2)=0.475 β=-0.018, P=0.0001). CONCLUSIONS Metabolic screening in prepubertal AGA born girls with PA may yield favorable lipid profiles. AI in girls with PA is increased in relation to decreasing IS and increasing BMI and WC. DHEAS seems to have the most significant effect on AI.
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Affiliation(s)
- Ahmet Uçar
- Correspondence should be addressed to A Uçar Email
| | | | | | - Nihal Hatipoğlu
- Pediatric Endocrine Unit, Erciyes Medical FacultyErciyes UniversityKayseriTurkey
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Savineau JP, Marthan R, Dumas de la Roque E. Role of DHEA in cardiovascular diseases. Biochem Pharmacol 2012; 85:718-26. [PMID: 23270992 DOI: 10.1016/j.bcp.2012.12.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 12/05/2012] [Accepted: 12/06/2012] [Indexed: 10/27/2022]
Abstract
Dehydroepiandrosterone (DHEA) is a steroid hormone derived from cholesterol synthesized by the adrenal glands. DHEA and its 3β-sulphate ester (DHEA-S) are the most abundant circulating steroid hormones. In human, there is a clear age-related decline in serum DHEA and DHEA-S and this has suggested that a relative deficiency in these steroids may be causally related to the development of a series of diseases associated with aging including cardiovascular diseases (CVD). This commentary aims to highlight the action of DHEA in CVD and its beneficial effect in therapy. We thus discuss the possible impact of serum DHEA decline and DHEA supplementation in diseases such as hypertension, coronary artery disease and atherosclerosis. More specifically, we provide evidence for a beneficial action of DHEA in the main disease of the pulmonary circulation: pulmonary hypertension. We also examine the potential cellular mechanism of action of DHEA in terms of receptors (membrane/nuclear) and associated signaling pathways (ion channels, calcium signaling, PI3K/AKT/eNos pathway, cGMP, RhoA/RhoK pathway). We show that DHEA acts as an anti-remodeling and vasorelaxant drug. Since it is a well-tolerated and inexpensive drug, DHEA may prove to be a valuable molecule in CVD but it deserves further studies both at the molecular level and in large clinical trials.
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Abstract
Female androgens are derived from either the adrenal and peripheral conversion of the adrenal sex steroid precursor, dehydroepiandrosterone, or from direct ovarian production. Adrenal insufficiency or bilateral oophorectomy (surgical menopause) result in severe androgen deficiency, which can be clinically associated with impaired libido, drive and energy. Physiological menopause does not necessarily lead to androgen deficiency. The previously suggested definition of female androgen deficiency syndrome, as the concurrent presence of low androgen levels and low libido, is not precise enough and may lead to overdiagnosis. Current replacement options include transdermal testosterone or oral dehydroepiandrosterone treatment, both of which have been shown to result in significant improvements, in particular in libido and mood, while long-term effects on body composition, cardiovascular and cancer risk are less documented. Owing to these concerns, androgen replacement should be reserved for women with severe androgen deficiency due to an established cause and matching clinical symptoms.
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Affiliation(s)
- Marie Lebbe
- a 1Centre for Endocrinology, Diabetes and Metabolism, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, B15 2TT, UK
| | - David Hughes
- a 1Centre for Endocrinology, Diabetes and Metabolism, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, B15 2TT, UK
| | - Nicole Reisch
- b 2Endocrine Research, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, 80336 Munich, Germany
| | - Wiebke Arlt
- a 1Centre for Endocrinology, Diabetes and Metabolism, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, B15 2TT, UK
- c 1Centre for Endocrinology, Diabetes and Metabolism, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, B15 2TT, UK.
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Abstract
OBJECTIVES Epidemiological studies show that women with pregnancies complicated by hypertension have an increased risk of cardiovascular morbidity later in life. The underlying mechanisms to the risk increase remain largely unknown. This study evaluated sympathetic nerve activity in women with hypertensive pregnancies 40 years earlier compared to women with normotensive pregnancies. We hypothesized that sympathetic outflow would be increased in women with previous hypertensive pregnancies and that this partly may explain the increased cardiovascular risk. METHODS Sympathetic nerve activity to the muscle vascular bed [muscle sympathetic nerve activity (MSNA)] was recorded in 28 women, 18 with and 10 without a hypertensive manifestation during pregnancy. Women were also examined with ambulatory blood pressure measurements, pulse wave velocity, blood pressure response during Stroop test and laboratory analysis. RESULTS Women with previous hypertensive pregnancies did not show an increased sympathetic outflow compared to women with normotensive pregnancies. In eight women with treated hypertension sympathetic outflow was increased compared to normotensive women despite similar ambulatory blood pressure values (P < 0.05). During Stroop test the hypertensive women showed increased systolic blood pressure and also displayed the highest augmentation index compared to normotensive women (P < 0.05). CONCLUSION Hypertensive pregnancies per se were not associated with increased sympathetic outflow 40 years later. The increased cardiovascular risk in women with previous hypertensive pregnancies cannot be explained by chronic activation of the sympathetic nervous system.In women with previous hypertensive pregnancies, still hypertensive though well controlled, sympathetic outflow and arterial stiffness were, however, increased compared to normotensive counterparts.
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Mieczkowska J, Mosiewicz J, Sak J, Grzybowski A, Terlecki P, Barud W, Kwaśniewski W, Tutka P. Effects of cigarette smoking, metabolic syndrome and dehydroepiandrosterone deficiency on intima-media thickness and endothelial function in hypertensive postmenopausal women. Med Sci Monit 2012; 18:CR225-34. [PMID: 22460094 PMCID: PMC3560833 DOI: 10.12659/msm.882622] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Cigarette smoking is a major risk factor of atherosclerosis. The aim of this study was to assess the relationship between smoking and arterial hypertension as well as endothelial dysfunction in postmenopausal women without clinically manifested symptoms of atherosclerosis. Material/Methods The study groups consisted of 35 current smokers and 45 nonsmokers. The thickness of intima-media complex (IMT), a marker of atherosclerosis, was measured in carotid arteries. Plasma concentrations of fasting glucose, insulin, lipoproteins, inflammatory markers (tumor necrosis factor-alpha, intercellular adhesion molecule-1), matrix metalloproteinases (metalloproteinase-9, tissue inhibitor of metalloproteinase-1), insulin, and dehydroepiandrosterone sulfate (DHEA-S) were measured. Results Smokers compared with nonsmokers showed lower fasting glucose levels in blood (87.0±10.9 and 93.2±13.6 mg/dl, p<0.05), higher mean systolic (131.1±15.9 vs. 123.0±10.9 mm Hg, p<0.05) and diastolic (81.7±11.4 vs. 75.2±9.2 mm Hg, p<0.05) blood pressure during daytime, and higher average heart rate during the daytime (78.2±9.3/min vs. 71.5±9.5/min, p<0.01) and at night (67.2±10.6/min vs. 61.7±7.7/min, p<0.05), respectively. The IMT in the right carotid artery was significantly higher in smokers than in nonsmokers (0.96±0.16 mm vs. 0.82±0.21, p<0.05) and was positively correlated with smoking intensity (R=0.36) and habit duration (R=0.35). The comparison of inflammatory markers, metalloproteinases, and DHEA-S concentrations in plasma did not reveal significant differences between the 2 groups. A significant negative correlation between DHEA-S concentration in plasma and IMT in right carotid artery was found in smokers. Conclusions Smoking in hypertensive postmenopausal women is associated with lower fasting blood glucose and BMI values, but higher arterial pressure and heart rate, and increases in IMT in right carotid artery.
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Affiliation(s)
- Jolanta Mieczkowska
- Department of Internal Medicine, Medical University of Lublin, Lublin, Poland
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15
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Traish AM, Kang HP, Saad F, Guay AT. Dehydroepiandrosterone (DHEA)—A Precursor Steroid or an Active Hormone in Human Physiology (CME). J Sex Med 2011; 8:2960-82; quiz 2983. [DOI: 10.1111/j.1743-6109.2011.02523.x] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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16
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Bhuiyan MS, Tagashira H, Fukunaga K. Dehydroepiandrosterone-mediated stimulation of sigma-1 receptor activates Akt-eNOS signaling in the thoracic aorta of ovariectomized rats with abdominal aortic banding. Cardiovasc Ther 2011; 29:219-30. [PMID: 20553277 DOI: 10.1111/j.1755-5922.2010.00196.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Decreased dehydroepiandrosterone (DHEA) levels are associated with endothelial dysfunction and increased cardiovascular mortality in postmenopausal women. Using ovariectomized rats, we first defined whether expression of sigma-1 receptor (Sig-1R) in the aorta is regulated following pressure overload (PO) and also after DHEA treatment. We also investigated effects of DHEA known as Sig-1R agonist on impaired Akt/endothelial nitric oxide synthase (eNOS) signaling in the thoracic aorta under PO. RESEARCH DESIGN/METHODS Wistar rats subjected to bilateral ovariectomy (OVX) were further treated with abdominal aortic stenosis 2 weeks later. DHEA (15 and 30 mg/kg) was administered orally once a day for 14 days starting from 2 weeks after the aortic banding. RESULTS Time course study indicated that expression of Sig-1R expression and eNOS decreased time dependently in the thoracic aorta from 1 to 4 weeks after PO. DHEA treatment significantly inhibited the decreased Sig-1R expression in the thoracic aorta. The DHEA treatment also significantly restored PO-induced impaired Akt phosphorylation and stimulated eNOS protein expression with concomitant increased Akt-mediated eNOS phosphorylation (Ser1177). We did not find any changes in the phosphorylation of ERK1/2 and PKCα in the aorta following PO and after treatment with DHEA. CONCLUSION We here reported, for the first time, that DHEA treatment induces the upregulation and stimulation of Sig-1R in the thoracic aorta that stimulate Sig-1R-mediated Akt-eNOS signaling pathways in ovariectomized rats under PO.
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Affiliation(s)
- Md Shenuarin Bhuiyan
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan
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Giordano R, Marzotti S, Balbo M, Romagnoli S, Marinazzo E, Berardelli R, Migliaretti G, Benso A, Falorni A, Ghigo E, Arvat E. Metabolic and cardiovascular profile in patients with Addison's disease under conventional glucocorticoid replacement. J Endocrinol Invest 2009; 32:917-23. [PMID: 19620820 DOI: 10.1007/bf03345773] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Although two studies have shown that Addison's disease (AD) is still a potentially lethal condition for cardiovascular, malignant, and infectious diseases, a recent retrospective study showed a normal overall mortality rate. Differently from secondary hypoadrenalism, scanty data exist on the role of conventional glucocorticoid replacement on metabolic and cardiovascular outcome in AD. SUBJECTS AND METHODS In 38 AD under conventional glucocorticoid replacement (hydrocortisone 30 mg/day or cortisone 37.5 mg/day) ACTH, plasma renin activity (PRA), DHEAS, fasting glucose and insulin, 2-h glucose after oral glucose tolerance test, serum lipids, 24-h blood pressure and intima-media thickness (IMT) were evaluated and compared with 38 age-, sex- and body mass index (BMI)-matched controls (CS). RESULTS AD had ACTH and PRA higher and DHEAS lower (p<0.0005) than CS. Mean waist was higher (p<0.05) in AD than in CS. Although no differences were found for mean gluco-lipids levels, a higher percentage of AD compared to CS were IGT (8 vs 0%), hypercholesterolemic (18 vs 8%), and hypertriglyceridemic (18 vs 8%); none of the AD and CS showed either HDL<40 mg/dl or LDL>190 mg/dl. At the multiple regression analysis, in both AD and CS, BMI was the best predictor of 2-h glucose and age of total and LDL cholesterol; in AD, no significant correlation was found between the above mentioned metabolic parameters and either hormone levels or disease duration. In both AD and CS 24-h blood pressure and IMT were normal. CONCLUSIONS Our study shows a higher prevalence of central adiposity, impaired glucose tolerance and dyslipidemia in AD patients.
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Affiliation(s)
- R Giordano
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, Italy
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18
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Lack of association between plasma Dehydroepiandrosterone Sulfate (DHEA-S) levels and depression in hemodialysis patients: A cross-sectional study. Exp Gerontol 2009; 44:733-9. [DOI: 10.1016/j.exger.2009.08.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Revised: 05/26/2009] [Accepted: 08/24/2009] [Indexed: 11/22/2022]
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Manolakou P, Angelopoulou R, Bakoyiannis C, Bastounis E. The effects of endogenous and exogenous androgens on cardiovascular disease risk factors and progression. Reprod Biol Endocrinol 2009; 7:44. [PMID: 19433001 PMCID: PMC2693125 DOI: 10.1186/1477-7827-7-44] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Accepted: 05/12/2009] [Indexed: 11/17/2022] Open
Abstract
Cardiovascular disease incidence rates have long been known to significantly differ between the two sexes. Estrogens alone fail to explain this phenomenon, bringing an increasing amount of attention to the role of androgens. Contrary to what was initially hypothesized, androgens seem to have an overall cardioprotective effect, especially in men. Recent studies and published data continue to support this notion displaying a consistent inverse correlation with atherosclerosis progression and cardiovascular disease both in regressive and prospective study models. Clinical studies have also revealed what seems to be a differential androgenic effect on various cardiovascular risk factors between men and women. Further insight indicates that in order to avoid confusion it may be also preferable to separately examine the effects of endogenous androgen levels from exogenous testosterone administration, as well as discern the differential results of low to normal and supraphysiological administration doses. This review summarizes old and recent data according to the above distinctions, in an attempt to further our understanding of the role of androgens in cardiovascular disease.
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Affiliation(s)
- Panagiota Manolakou
- Department of Histology and Embryology, Medical School, National and Kapodistrian University of Athens, Greece
| | - Roxani Angelopoulou
- Department of Histology and Embryology, Medical School, National and Kapodistrian University of Athens, Greece
| | - Chris Bakoyiannis
- First Department of Surgery, National and Kapodistrian University of Athens Medical School, Laiko Hospital, Athens, Greece
| | - Elias Bastounis
- First Department of Surgery, National and Kapodistrian University of Athens Medical School, Laiko Hospital, Athens, Greece
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Hormonal Regulation of the Vascular System: An Overview. Cardiovasc Endocrinol 2008. [DOI: 10.1007/978-1-59745-141-3_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Ouyang P, Vaidya D, Dobs A, Golden SH, Szklo M, Heckbert SR, Kopp P, Gapstur SM. Sex hormone levels and subclinical atherosclerosis in postmenopausal women: the Multi-Ethnic Study of Atherosclerosis. Atherosclerosis 2008; 204:255-61. [PMID: 18849030 DOI: 10.1016/j.atherosclerosis.2008.08.037] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2008] [Revised: 08/28/2008] [Accepted: 08/28/2008] [Indexed: 12/31/2022]
Abstract
We examined cross-sectional associations between sex hormones and carotid artery intimal-medial thickness (cIMT) and coronary artery calcium in women in the Multi-Ethnic Study of Atherosclerosis. Serum testosterone, estradiol, sex hormone binding globulin (SHBG), and dehydroepiandrosterone levels were measured in 1947 postmenopausal women aged 45-84 years (30% White, 14% Chinese-American, 31% Black, and 25% Hispanic) and not on hormone therapy. Using multiple linear regression we evaluated associations between log(sex hormone) levels and log(cIMT) adjusted for age, ethnicity, body mass index (BMI) and cardiac risk factors. Associations between sex hormone levels and the presence and extent of coronary calcium were evaluated. Total and bioavailable testosterone were positively associated with common cIMT independent of age, BMI, hypertension, smoking, HDL-cholesterol, LDL-cholesterol and insulin sensitivity (p=0.009 and p=0.002, respectively). SHBG was negatively associated with common cIMT (p=0.001) but further adjustment for BMI, cardiovascular risk factors, and LDL- and HDL-cholesterol removed significance. Estradiol and dehydroepiandrosterone were not associated with common cIMT. Sex hormones were not associated with presence of coronary calcium. Among women with measurable coronary calcium, higher SHBG (p=0.012) and lower bioavailable testosterone (p=0.007) were associated with greater coronary calcium score. No heterogeneity by ethnicity was found. In postmenopausal women, testosterone is independently associated with greater common cIMT. SHBG is negatively associated and this may be mediated by LDL- and HDL-cholesterol. In contrast, SHBG and testosterone were associated with extent of coronary calcium but in the opposite direction compared to carotid intimal-medial thickness. These differences warrant further evaluation.
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Kanazawa I, Yamaguchi T, Yamamoto M, Yamauchi M, Kurioka S, Yano S, Sugimoto T. Serum DHEA-S level is associated with the presence of atherosclerosis in postmenopausal women with type 2 diabetes mellitus. Endocr J 2008; 55:667-75. [PMID: 18493102 DOI: 10.1507/endocrj.k07e-130] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We investigated the relationship between serum dehydroepiandrosterone-sulfate (DHEA-S) and insulin-like growth factor-I (IGF-I) to various parameters for atherosclerosis in type 2 diabetes. The levels of DHEA-S and IGF-I are known to decrease with aging and thereby might be associated with an increased risk of cardiovascular disease. One hundred forty-eight men and 106 postmenopausal women with type 2 diabetes were assessed in a cross-sectional study. Serum DHEA-S and IGF-I concentrations were measured and brachial-ankle pulse wave velocity (baPWV) and ultrasonographically-evaluated intima-media thickness (IMT) were assessed. Although simple regression analysis showed that log(DHEA-S) and IGF-I in men and log(DHEA-S) in women were significantly and inversely correlated with baPWV and IMT, only log(DHEA-S) in women was still significantly and inversely correlated with these atherosclerotic parameters after multiple regression analysis was adjusted for age, duration of diabetes, BMI, HbA(1C), systolic blood pressure, LDL-Cholesterol (C), serum creatinine, and smoking (Brinkman index). Serum DHEA-S level seemed to be associated with atherosclerosis in diabetic postmenopausal women independent of age, body stature, diabetic status, and other atherosclerotic risk factors, and might be a useful addition to other parameters for assessing the risk of atherosclerosis in this population.
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Affiliation(s)
- Ippei Kanazawa
- Department of Internal Medicine 1, Shimane University Faculty of Medicine, Japan
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Peter I, Kelley-Hedgepeth A, Fox CS, Cupples LA, Huggins GS, Housman DE, Karas RH, Mendelsohn ME, Levy D, Murabito JM. Variation in estrogen-related genes associated with cardiovascular phenotypes and circulating estradiol, testosterone, and dehydroepiandrosterone sulfate levels. J Clin Endocrinol Metab 2008; 93:2779-85. [PMID: 18445666 PMCID: PMC2453049 DOI: 10.1210/jc.2008-0106] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Younger age at the onset of menopause and lower circulating levels of estrogen are risk factors for cardiovascular disease. Several studies have detected associations between variations in genes encoding estrogen receptors alpha (ESR1) and beta (ESR2), and enzyme aromatase (CYP19A1), which regulates the estrogen to testosterone ratio, and cardiovascular phenotypes in the Framingham Heart Study. To explore potential mechanisms by which these gene variants may contribute to cardiovascular disease, we tested the hypothesis that the polymorphisms were associated with endogenous steroid hormone levels. METHODS Multiple regression analysis was used to assess the relation between reported polymorphisms and total serum estradiol, testosterone, and dehydroepiandrosterone sulfate levels in 834 men and 687 women who attended the third and fourth Framingham Heart Study examination cycles. RESULTS In men, significant associations were detected between CYP19A1 polymorphisms and estradiol and testosterone levels, and the estradiol to testosterone ratio (P ranges 0.0005-0.01). Specifically, carriers of common haplotype rs700518[G]-(TTTA)(n) [L]-rs726547[C] had higher estradiol levels (5% per copy; P = 0.0004), lower testosterone levels (17% per copy; P = 0.036), and a higher estradiol to testosterone ratio (24% per copy; P < 0.0001) compared with the rs700518[A]-(TTTA)(n) [S]-rs726547[C] carriers. In addition, postmenopausal carriers of the ESR2 (CA)(n) long allele and rs1256031 [C] allele had moderately higher estradiol levels (P < or = 0.03). No significant associations with the ESR1 variants were detected. CONCLUSIONS Our findings suggest that variations in CYP19A1 correlate with steroid hormone levels in men. Knowledge that a specific carrier status may predispose to altered steroid hormone levels may lead to targeted intervention strategies to reduce health risks in genetically susceptible individuals.
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Affiliation(s)
- Inga Peter
- Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA.
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24
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Enomoto M, Adachi H, Fukami A, Furuki K, Satoh A, Otsuka M, Kumagae SI, Nanjo Y, Shigetoh Y, Imaizumi T. Serum dehydroepiandrosterone sulfate levels predict longevity in men: 27-year follow-up study in a community-based cohort (Tanushimaru study). J Am Geriatr Soc 2008; 56:994-8. [PMID: 18422949 DOI: 10.1111/j.1532-5415.2008.01692.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine whether serum dehydroepiandrosterone sulfate (DHEAS) levels could predict longevity in residents. DESIGN Prospective community-based cohort study. SETTING Community. PARTICIPANTS Nine hundred forty subjects (396 men, 544 women; aged 21 to 88) underwent a health examination in 1978. Serum DHEAS levels were measured according to radioimmunoassay at baseline in all subjects, and subjects were followed periodically until 2005. RESULTS Baseline DHEAS levels were higher in men than in women and decreased with age in both sexes. In a Cox proportional hazards model, age, DHEAS (inversely), blood pressure, and fasting plasma glucose were significantly associated with shorter longevity in men but not in women. Of these variables, high DHEAS levels in men were the strongest predictor of longevity (beta=-2.032, hazard ratio=0.131, 95% confidence interval=0.029-0.584 in the Cox proportional hazards model after adjustment for age). The Kaplan-Meier survival curve, stratified according to tertiles of DHEAS levels, in men after adjustments for age, systolic blood pressure, and fasting plasma glucose showed significantly (log-rank stat =10.6; P<.001) greater longevity in the highest group (200 microg/dL) than in the moderate (130-199 microg/dL) or lowest groups (129 microg/dL). CONCLUSION This 27-year study in a community-based cohort indicated that DHEAS level may be a predictor of longevity in men, independent of age, blood pressure, and plasma glucose.
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Affiliation(s)
- Mika Enomoto
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume University School of Medicine, Kurume, Japan
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Li Q, Li Y, Zhang Z, Gilbert TR, Matsumoto AH, Dobrin SE, Shi W. Quantitative trait locus analysis of carotid atherosclerosis in an intercross between C57BL/6 and C3H apolipoprotein E-deficient mice. Stroke 2008; 39:166-73. [PMID: 18048852 PMCID: PMC2245805 DOI: 10.1161/strokeaha.107.492165] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2007] [Accepted: 06/05/2007] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Inbred mouse strains C57BL/6J (B6) and C3H/HeJ (C3H) exhibit marked differences in atherosclerotic lesion formation in the carotid arteries on the apolipoprotein E-deficient (apoE(-/-)) background when fed a Western diet. Quantitative trait locus analysis was performed on an intercross between B6.apoE(-/-) and C3H.apoE(-/-) mice to determine genetic factors contributing to variation in the phenotype. METHODS Female B6.apoE(-/-) mice were crossed with male C3H.apoE(-/-) mice to generate F(1) hybrids, which were intercrossed to generate 241 female F(2) progeny. At 6 weeks of age, F(2) mice were started on a Western diet. After being fed the diet for 12 weeks, F(2) mice were analyzed for phenotypes such as lesion size in the left carotid arteries and plasma lipid levels and typed for 154 genetic markers spanning the mouse genome. RESULTS One significant quantitative trait locus, named CAth1 (25 cM, log of the odds score: 4.5), on chromosome 12 and 4 suggestive quantitative trait loci, on chromosomes 1, 5, 6, and 11, respectively, were identified to influence carotid lesion size. One significant quantitative trait locus on distal chromosome 1 accounted for major variations in plasma low-density lipoprotein/very-low-density lipoprotein, high-density lipoprotein cholesterol, and triglyceride levels. Carotid lesion size was not significantly correlated with plasma low-density lipoprotein/very-low-density lipoprotein or high-density lipoprotein cholesterol levels. CONCLUSIONS These data indicate that the loci for carotid lesions do not overlap with those for aortic lesions as identified in a previous cross derived from the same parental strains, and carotid atherosclerosis and plasma lipids are controlled by separate genetic factors in the B6 and C3H mouse model.
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Affiliation(s)
- Qiongzhen Li
- Department of Radiology and the Cardiovascular Research Center, University of Virginia, Charlottesville, VA 22908, USA
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Choi BG, McLaughlin MA. Why men's hearts break: cardiovascular effects of sex steroids. Endocrinol Metab Clin North Am 2007; 36:365-77. [PMID: 17543724 DOI: 10.1016/j.ecl.2007.03.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Coronary artery disease (CAD) mortality differs in men and women, leading to the speculation that differences in sex steroids contribute to risk. Controlled clinical trials have shown that estrogen replacement is not cardioprotective in certain women, and recent cross-sectional studies associate low testosterone with a greater incidence of CAD in men. Testosterone has demonstrated effects on insulin resistance, obesity, myocardium, coagulation, inflammation, vasodilation, and endothelial function. Imbalance of sex steroids contributes to adverse cardiac effects in men.
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Affiliation(s)
- Brian G Choi
- The Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1030, New York, NY 10029, USA
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Goldman N, Glei DA. Sex differences in the relationship between DHEAS and health. Exp Gerontol 2007; 42:979-87. [PMID: 17604586 PMCID: PMC2968710 DOI: 10.1016/j.exger.2007.05.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Revised: 04/16/2007] [Accepted: 05/15/2007] [Indexed: 11/29/2022]
Abstract
Dehydroepiandrosterone (DHEA) and its sulfate form (DHEAS) have been the focus of considerable publicity because of their demonstrated associations with a broad range of health outcomes. Yet, knowledge about the effects of endogenous DHEA(S) on health in humans is limited and often inconclusive, largely because few of the studies have been based on prospective surveys of population-representative samples. This analysis uses a national longitudinal survey in Taiwan to investigate whether DHEAS is associated with subsequent changes (2000-2003) in functional limitations, cognitive impairment, depressive symptoms, and global self-rated health. Regression models based on this older Taiwanese sample show that among men, lower levels of DHEAS are related to declines in mobility and self-assessed health status and increases in depressive symptoms, while both low and very high levels of DHEAS are associated with poor cognitive function. There are no significant associations among women. These findings differ from those in a previous cross-sectional analysis based on the Taiwan study and underscore the importance of using prospective data to examine the effects of DHEAS on health. The evidence based on this and other longitudinal studies suggests that endogenous DHEAS is related to health outcomes for men, but not women, in both Western and non-Western populations.
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Affiliation(s)
- Noreen Goldman
- Office of Population Research, Princeton University, USA
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Pierucci-Lagha A, Covault J, Feinn R, Khisti RT, Morrow AL, Marx CE, Shampine LJ, Kranzler HR. Subjective effects and changes in steroid hormone concentrations in humans following acute consumption of alcohol. Psychopharmacology (Berl) 2006; 186:451-61. [PMID: 16341848 DOI: 10.1007/s00213-005-0231-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2005] [Accepted: 10/05/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND GABAA receptors are an important site of action of endogenous neurosteroids and an important mediator of several behavioral effects of alcohol. This study examined the effects of alcohol on plasma steroid hormone concentrations on the hypothesis that the endocrine effects mediate some of the subjective effects of alcohol. METHODS Thirty-two healthy subjects (17 men) with no history of a substance use disorder participated in this human laboratory study. All subjects consumed three standard drinks of grain alcohol. Subjective measures and blood samples for steroid concentrations were collected at baseline and 40 min after alcohol consumption. RESULTS Alcohol increased self-reported stimulation, alcohol liking, and desire for more alcohol. Alcohol also increased pregnenolone (PREG) and dehydroepiandrosterone (DHEA) concentrations, while it decreased progesterone (PROG) and allopregnanolone (ALLO) concentrations, as well as ALLO/PREG and PROG/PREG ratios. In men, the change in PREG concentration was significantly correlated with alcohol liking, while the alcohol-induced change in ALLO concentration correlated significantly with both alcohol liking and desire for more alcohol. DISCUSSION These findings provide preliminary support for the hypothesis that endogenous neurosteroids mediate some of the subjective effects of alcohol. Efforts to replicate these findings should aim to specify more clearly the nature and time course of the effects.
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Affiliation(s)
- Amira Pierucci-Lagha
- Department of Psychiatry, Alcohol Research Center, University of Connecticut School of Medicine, Farmington, CT 06030, and Department of Psychiatry and Behavioral Sciences, Durham VA Medical Center, NC 27705, USA
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Svartberg J, von Mühlen D, Mathiesen E, Joakimsen O, Bønaa KH, Stensland-Bugge E. Low testosterone levels are associated with carotid atherosclerosis in men. J Intern Med 2006; 259:576-82. [PMID: 16704558 DOI: 10.1111/j.1365-2796.2006.01637.x] [Citation(s) in RCA: 129] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To study the relationship between endogenous sex hormone levels and intima-media thickness (IMT) of the carotid artery measured by ultrasonography. DESIGN Population-based cross-sectional study. METHODS Sex hormone levels measured by immunoassay, anthropometric measurements and IMT was studied in 1482 men aged 25-84 years participating in the 1994-1995 Tromsø study. The data were analysed with partial correlation, multiple linear regression and logistic regression analysis. RESULTS Linear regression models showed that total testosterone and sex hormone-binding globulin levels, but not calculated free testosterone, serum oestradiol or dehydroepiandrosterone sulphate levels were inversely associated with the age-adjusted IMT (P = 0.008 and P < 0.001 respectively). These associations were independent of smoking, physical activity, blood pressure and lipid levels, but were not independent of body mass index (BMI). Excluding men with cardiovascular disease (CVD) did not materially change these results. In a logistic regression model adjusted for the confounding effect of CVD risk factors, men with testosterone levels in the lowest quintile (<9.0 nmol L(-1)) had an independent OR = 1.51 (P = 0.015) of being in the highest IMT quintile. CONCLUSIONS We found an inverse association between total testosterone levels and IMT of the carotid artery in men that was present also after excluding men with CVD, but was not independent of BMI. The clinical relevance of this, however, is uncertain and needs to be investigated in a clinical setting.
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Affiliation(s)
- J Svartberg
- Department of Medicine, University Hospital of North Norway, Tromsø, Norway.
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Hougaku H, Fleg JL, Najjar SS, Lakatta EG, Harman SM, Blackman MR, Metter EJ. Relationship between androgenic hormones and arterial stiffness, based on longitudinal hormone measurements. Am J Physiol Endocrinol Metab 2006; 290:E234-42. [PMID: 16159908 DOI: 10.1152/ajpendo.00059.2005] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Circulating testosterone levels (T) decrease with age in men. Low T has been associated with coronary disease and with risk factors for atherosclerosis. This study examines the relationship in men between androgenic hormones and arterial stiffness, a major risk factor for cardiovascular events. T, sex hormone-binding globulin (SHBG), and dehydroepiandrosterone sulfate (DHEAS) were measured longitudinally over 33 yr (follow-up 11.8 +/- 8.3 yr) in 901 men from the Baltimore Longitudinal Study of Aging, of whom 206 (68.1 +/- 13.7 yr) underwent carotid duplex ultrasonography. The 901 men were used to characterize age-associated hormone levels by means of mixed-effects models. Hormone values were estimated for the 206 men at the time of ultrasonography. Free T index (FTI) was calculated by dividing T by SHBG. The arterial stiffness index was calculated from peak systolic and end diastolic diameters of the common carotid artery and simultaneous brachial artery blood pressure. T, FTI, and DHEAS were correlated negatively with age, pulse pressure (PP), and stiffness index (each P < 0.01), whereas SHBG was correlated positively with age and stiffness index (P < 0.01). However, T was the only hormone that predicted the stiffness index after adjustment for age, PP, fasting plasma glucose, body mass index, and total cholesterol. T values 5-10 yr before the carotid study also predicted the stiffness index (P < 0.05). Thus the adverse influence of low T on the cardiovascular system in men may be mediated in part via the effects of T on vascular structure and function.
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Affiliation(s)
- Hidetaka Hougaku
- Clinical Research Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21225, USA
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Boudou P, Sobngwi E, Ibrahim F, Porcher R, Vexiau P, Calvo F, Gautier JF. Hyperglycaemia acutely decreases circulating dehydroepiandrosterone levels in healthy men. Clin Endocrinol (Oxf) 2006; 64:46-52. [PMID: 16402927 DOI: 10.1111/j.1365-2265.2005.02414.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study was conducted in order to evaluate the effect of glucose-insulin homeostasis on adrenal steroids and was designed to separate the effects of hyperglycaemia from those of insulin. DESIGN Eight healthy men aged 22.6 +/- 3.4 (SD) underwent an 80 mU/m2/min hyperinsulinaemic euglycaemic 100-min clamp, a 200-min graded glucose infusion at 2-16 mg/kg/min and a measurement of fat mass. MEASUREMENTS Circulating glucose, insulin and adrenal steroid levels including dehydroepiandrosterone (DHEA) were determined before and during both infusion tests. Steroid variations in relation to insulinaemia and glycaemia were analysed using univariate, multivariate tests and nonlinear mixed models. RESULTS Hyperinsulinaemia induced no significant modification of adrenal steroid levels. By contrast, hyperglycaemia decreased all adrenal steroids except DHEA-sulphate by 47-66%. The drop occurred early, averaging 51% for 17OH pregnenolone and 57% for DHEA at the 80th minute of glucose infusion, whereas blood glucose was 7.1 +/- 1.2 mmol/1. This effect was independent of insulinaemia, fat mass and waist circumference. Thus, we estimated models that could best predict steroid variations according to blood glucose. At thresholds defining impaired fasting glycaemia and diabetes, the estimated decrease in DHEA was 40% and 45%, respectively, culminating at 60% at 9.3 mmol/1 glycaemia, with no detectable further decrease. CONCLUSIONS Our data suggest that hyperglycaemia dramatically decreases adrenal androgen levels in men, possibly by acting at early steps of synthesis, independently of insulinaemia and fat mass.
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Affiliation(s)
- P Boudou
- Department of Hormonal Biology, Saint-Louis Hospital, Assistance Publique--Hopitaux de Paris (AP-HP), University of Paris VII-Medical School, Paris 10, France.
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Kaufman JM, Vermeulen A. The decline of androgen levels in elderly men and its clinical and therapeutic implications. Endocr Rev 2005; 26:833-76. [PMID: 15901667 DOI: 10.1210/er.2004-0013] [Citation(s) in RCA: 698] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Aging in men is accompanied by a progressive, but individually variable decline of serum testosterone production, more than 20% of healthy men over 60 yr of age presenting with serum levels below the range for young men. Albeit the clinical picture of aging in men is reminiscent of that of hypogonadism in young men and decreased testosterone production appears to play a role in part of these clinical changes in at least some elderly men, the clinical relevancy of the age-related decline in sex steroid levels in men has not been unequivocally established. In fact, minimal androgen requirements for elderly men remain poorly defined and are likely to vary between individuals. Consequently, borderline androgen deficiency cannot be reliably diagnosed in the elderly, and strict differentiation between "substitutive" and "pharmacological" androgen administration is not possible. To date, only a few hundred elderly men have received androgen therapy in the setting of a randomized, controlled study, and many of these men were not androgen deficient. Most consistent effects of treatment have been on body composition, but to date there is no evidence-based documentation of clinical benefits of androgen administration to elderly men with normal or moderately low serum testosterone in terms of diminished morbidity or of improved survival or quality of life. Until the long-term risk-benefit ratio for androgen administration to elderly is established in adequately powered trials of longer duration, androgen administration to elderly men should be reserved for the minority of elderly men who have both clear clinical symptoms of hypogonadism and frankly low serum testosterone levels.
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Affiliation(s)
- Jean M Kaufman
- Department of Endocrinology, Ghent University Hospital, Ghent B-9000, Belgium.
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Fukui M, Kitagawa Y, Nakamura N, Kadono M, Yoshida M, Hirata C, Wada K, Hasegawa G, Yoshikawa T. Serum dehydroepiandrosterone sulfate concentration and carotid atherosclerosis in men with type 2 diabetes. Atherosclerosis 2005; 181:339-44. [PMID: 16039288 DOI: 10.1016/j.atherosclerosis.2005.01.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2003] [Revised: 10/12/2004] [Accepted: 01/03/2005] [Indexed: 10/25/2022]
Abstract
Decreased serum dehydroepiandrosterone (DHEA) concentrations may be associated with an increased risk of cardiovascular disease (CVD) in men. We evaluated relationships between serum DHEA sulfate (DHEA-S) concentration and carotid atherosclerosis, as well as major cardiovascular risk factors, in men with type 2 diabetes. Serum DHEA-S concentrations were measured in 206 consecutive men with type 2 diabetes. Relationships were analyzed between serum DHEA-S concentration and carotid atherosclerosis, determined by ultrasonographically evaluated intima-media thickness (IMT) and plaque score (PS), as well as major cardiovascular risk factors, including age, blood pressure, and lipid concentrations. Negative correlations were found between DHEA-S concentration and IMT (r = -0.298, P < 0.0001) and between DHEA-S concentration and PS (r = -0.308, P < 0.0001). IMT and PS were significantly greater in patients with lower concentrations of DHEA-S (<1000 ng/ml) than in patients with higher concentrations of DHEA-S (1.07+/-0.30 mm versus 0.91+/-0.19 mm, P < 0.0001, and 5.5+/-4.2 versus 3.1+/-3.4, P < 0.0001, respectively). A negative correlation was found between serum DHEA-S concentration and age (r = -0.488, P < 0.0001). Multiple regression analysis demonstrated that serum DHEA-S concentration was an independent determinant of IMT (beta = -0.289, P < 0.0001) and of PS (beta = -0.301, P < 0.0001). In conclusion, serum DHEA-S concentration is negatively associated with carotid atherosclerosis determined by ultrasonographically evaluated IMT and PS in men with type 2 diabetes.
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Affiliation(s)
- Michiaki Fukui
- The Department of Endocrinology and Hematology, Osaka General Hospital of West Japan Railway Company, 1-2-22 Matsuzaki-cho, Osaka 545-0053, Japan.
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Kameda W, Daimon M, Oizumi T, Jimbu Y, Kimura M, Hirata A, Yamaguchi H, Ohnuma H, Igarashi M, Tominaga M, Kato T. Association of decrease in serum dehydroepiandrosterone sulfate levels with the progression to type 2 diabetes in men of a Japanese population: the Funagata Study. Metabolism 2005; 54:669-76. [PMID: 15877298 DOI: 10.1016/j.metabol.2004.12.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Association of serum dehydroepiandrosterone sulfate (DHEAS) levels with insulin resistance and impairment of insulin secretion have been reported. We here examined the association of serum DHEAS levels with type 2 diabetes mellitus (DM) and the progression to DM. The serum DHEAS levels at baseline (from 1995 to 1997) were evaluated in 1709 individuals (998 women and 711 men) from a cohort population (n = 3706) of the Funagata Study. Glucose tolerance was evaluated at baseline as well as at 5-year follow-up examinations (n = 970, follow-up rate, 56.8%) according to the 1985 World Health Organization criteria. The statistical significance of the difference between any 2 groups was determined by the Student t test. Multiple logistic regression analysis determined the association of the traits with the progression to DM at the 5-year follow-up examinations. P < .05 was accepted as statistically significant. The serum DHEAS levels were significantly lower in DM than in normal glucose tolerance. However, this difference was not significant when adjusted for age. In men, the decrease in serum DHEAS levels by the 5-year follow-up examinations was significantly larger in the subjects who became diabetic than in the subjects who remained normal glucose tolerance, even when adjusted for age ( P = .0003). Multiple logistic regression analysis revealed a significant association of the decrease in serum DHEAS levels with the progression to DM, with an odds ratio (per 0.1 log ng/mL) of 1.410 (95% confidence interval [CI], 1.020-1.948, P = .038), independently from age, height, and 2-hour plasma glucose in men. A decrease in serum DHEAS levels seems to be associated with the progression to DM in Japanese men.
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Affiliation(s)
- Wataru Kameda
- Third Department of Internal Medicine, Yamagata University School of Medicine, Yamagata 990-9585, Japan
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Abstract
BACKGROUND The aim of this study was to evaluate serum lipids and atherosclerosis risk in children with premature adrenarche (PA) in comparison with age-matched controls. METHODS Lipid profile, glucose, insulin, and insulin-like growth factor binding protein-1 (IGFBP-1) levels were studied in 24 girls with premature adrenarche and 13 healthy age-matched controls after overnight fasting. RESULTS The bone age, weight and body mass index were higher in the premature adrenarche group than the control group. Systolic, diastolic and mean arterial blood pressure of patients were higher than controls. The mean total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), very low-density lipoprotein-cholesterol (VLDL-C), TC/high-density lipoprotein-cholesterol (HDL-C) and LDL-C/HDL-C ratio, and atherogenic index were significantly higher in the premature adrenarche group compared to the control group. There was no significant difference in the levels of apolipoprotein A1, apolipoprotein B and lipoprotein (a) in both groups. In the premature adrenarche group there were inverse correlations between the levels of IGFBP-1 and TC/HDL-C (rho, -0.54; P, 0.011), and LDL-C/HDL-C (rho, -0.50; P < 0.05) and atherogenic index (AI; rho, -0.54; P < 0.05). Dehydroepiandrosterone sulfate levels of the patients was negatively correlated with AI and TC/HDL-C (rho, -0.0503, P < 0.05). CONCLUSIONS Girls with premature adrenarche should be investigated for serum lipids, and atherogenic risk criteria should be assessed periodically in the follow up of patients with PA, as PA seems to be a risk factor for future atherosclerosis.
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Affiliation(s)
- Ayla Güven
- Medical Faculty, Department of Pediatrics, Division of Pediatric Endocrinology, Gazi University, Ankara, Turkey.
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Abstract
Dehydroepiandrosterone (DHEA) therapy is controversial due to sensationalized reports of epidemiologic studies and the over-the-counter availability of DHEA. Human clinical trials have investigated the potential efficacy of DHEA therapy in multiple conditions with resultant inconsistencies in findings. DHEA is unique compared with other adrenal steroids because of the fluctuation in serum levels found from birth into advancing age. The lower endogenous levels of DHEA and DHEA sulfate found in advancing age have been correlated with a myriad of health conditions. Also, some studies suggest gender-specific actions of endogenous and exogenous DHEA. We reviewed only pharmacokinetic studies and human clinical trials investigating the efficacy of DHEA therapy that were placebo-controlled as these provided the most reliable scientific basis for the evaluation of DHEA therapy. Pharmacodynamic studies suggest that doses of 30-50mg of oral DHEA may produce physiologic androgen levels, especially in women. These studies report a dose-dependent effect and lack of accumulation of serum androgen levels. Pharmacologic studies also reveal a gender-specific response to DHEA therapy such that testosterone levels are increased in women but not in men. Clinical trials suggest that 50mg of oral DHEA, but not <30mg, can increase serum androgen levels to within the physiologic range for young adults with primary and secondary adrenal insufficiency, possibly improve sexual function, improve mood and self-esteem, and decrease fatigue/exhaustion. Whereas DHEA replacement therapy may be effective in treating patients with adrenal insufficiency, human clinical trials investigating its efficacy in conditions such as systemic lupus erythematosus, HIV, Alzheimer disease, advancing age, male sexual dysfunction, perimenopausal symptoms, depression, and cardiovascular disease have not provided consistent findings.
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Affiliation(s)
- Deborah R Cameron
- Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA
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Sierksma A, Sarkola T, Eriksson CJP, van der Gaag MS, Grobbee DE, Hendriks HFJ. Effect of moderate alcohol consumption on plasma dehydroepiandrosterone sulfate, testosterone, and estradiol levels in middle-aged men and postmenopausal women: a diet-controlled intervention study. Alcohol Clin Exp Res 2004; 28:780-5. [PMID: 15166654 DOI: 10.1097/01.alc.0000125356.70824.81] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Moderate alcohol consumption is inversely associated with cardiovascular diseases. Changes in hormone levels might in part help explain the positive health effect. This study was performed to examine the effect of moderate alcohol consumption on plasma dehydroepiandrosterone sulfate (DHEAS), testosterone, and estradiol levels. METHODS In a randomized, diet-controlled, crossover study, 10 middle-aged men and 9 postmenopausal women, all apparently healthy, nonsmoking, and moderate alcohol drinkers, consumed beer or no-alcohol beer with dinner during two successive periods of 3 weeks. During the beer period, alcohol intake equaled 40 and 30 g per day for men and women, respectively. The total diet was supplied and had essentially the same composition during these 6 weeks. Before each treatment there was a 1 week washout period, in which the subjects were not allowed to drink alcoholic beverages. At the end of each of the two experimental periods, fasting blood samples were collected in the morning. RESULTS Moderate alcohol consumption increased plasma DHEAS level by 16.5% (95% confidence interval, 8.0-24.9), with similar changes for men and women. Plasma testosterone level decreased in men by 6.8% (95% confidence interval, -1.0- -12.5), but no effect was found in women. Plasma estradiol level was not affected. Serum high-density lipoprotein cholesterol level increased by 11.7% (95% confidence interval, 7.3-16.0), with similar changes for men and women. The overall alcohol-induced relative changes in DHEAS, testosterone, and estradiol correlated positively with the relative increase in high-density lipoprotein cholesterol (adjusted for the relative change in body weight); however, findings were only borderline significant for DHEAS and estradiol (r = 0.44, p = 0.08; r = 0.32, p = 0.21; and r = 0.46, p = 0.06, respectively). CONCLUSIONS A protective effect of moderate alcohol consumption for cardiovascular disease risk may in part be explained by increased plasma DHEAS level.
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Affiliation(s)
- Aafje Sierksma
- Department of Nutritional Physiology, TNO Nutrition and Food Research, Zeist, The Netherlands
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Ng MKC, Nakhla S, Baoutina A, Jessup W, Handelsman DJ, Celermajer DS. Dehydroepiandrosterone, an adrenal androgen, increases human foam cell formation: a potentially pro-atherogenic effect. J Am Coll Cardiol 2004; 42:1967-74. [PMID: 14662261 DOI: 10.1016/j.jacc.2003.07.024] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We studied the effects of dehydroepiandrosterone (DHEA), an abundant adrenal androgen on two key early events of atherogenenis: 1) human monocyte adhesion to vascular endothelium, and 2) human foam cell formation. BACKGROUND In the U.S., where DHEA is available without prescription, there has recently been a rapid increase in unsupervised self-administration of DHEA. The vascular biologic effects of DHEA are largely unknown, however. METHODS Regarding adhesion, human umbilical vein endothelial cells (HUVECs), exposed to either DHEA (42 or 420 nmol/l) or control, were incubated with human monocytes, and adhesion was measured by hemocytometry. Surface expression of endothelial cell adhesion molecules was measured by ELISA. Regarding foam cell formation, studies of lipid loading were performed on macrophages treated with DHEA or control and/or the androgen receptor antagonist hydroxyflutamide (HF) (4 micromol/l). Intracellular cholesterol and cholesteryl esters (CE) were quantified by high-performance liquid chromatography. Expression of foam cell formation-related genes was measured by reverse-transcription polymerase chain reaction. RESULTS DHEA produced a dose-dependent receptor-mediated increase in the male macrophage CE content (up to 120 +/- 4% of control values, p = 0.015). DHEA upregulated messenger ribonucleic acid expression of the lipoprotein-processing enzymes acyl coenzyme A:cholesterol acyltransferase I and lysosomal acid lipase by 3.4- and 5.3-fold, respectively (p < 0.05 vs. control), but had no effect on scavenger receptor expression (p > 0.2). There was no significant effect of DHEA on monocyte-endothelial adhesion (<10% change in values, p = 0.56) or endothelial cell expression of cell adhesion molecules (p > 0.1). CONCLUSIONS DHEA increases human macrophage foam cell formation, a potentially pro-atherogenic effect. This effect appears to be mediated via the androgen receptor and involves the upregulation of lipoprotein-processing enzymes.
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Affiliation(s)
- Martin K C Ng
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
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Muller M, van der Schouw YT, Thijssen JHH, Grobbee DE. Endogenous sex hormones and cardiovascular disease in men. J Clin Endocrinol Metab 2003; 88:5076-86. [PMID: 14602729 DOI: 10.1210/jc.2003-030611] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Unlike women, men do not experience an abrupt reduction in endogenous sex hormone production. It has, however, become clear that an age-associated decrease in the levels of (bioactive) sex hormones does occur. Whether endogenous sex hormones have an impact on cardiovascular disease has for many years remained largely unknown, but during the last decade more attention has been drawn to the importance of testosterone, estrogens, and adrenal androgens in etiology, prevention, and treatment of male cardiovascular disease. The purpose of this article is to summarize the evidence currently available on the association between endogenous sex hormones and cardiovascular disease in males. Published studies dealing with the relationship between circulating levels of sex hormones and cardiovascular disease in males were reviewed. The studies reviewed in this article suggest that circulating endogenous sex hormones and estrogens have a neutral or beneficial effect on cardiovascular disease in men.
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Affiliation(s)
- Majon Muller
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands
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Abstract
A significant and independent association between endogenous testosterone (T) levels and coronary events in men and women has not been confirmed in large prospective studies, although cross-sectional data have suggested coronary heart disease can be associated with low T in men. Hypoandrogenemia in men and hyperandrogenemia in women are associated with visceral obesity; insulin resistance; low high-density lipoprotein (HDL) cholesterol (HDL-C); and elevated triglycerides, low-density lipoprotein cholesterol, and plasminogen activator type 1. These gender differences and confounders render the precise role of endogenous T in atherosclerosis unclear. Observational studies do not support the hypothesis that dehydroepiandrosterone sulfate deficiency is a risk factor for coronary artery disease. The effects of exogenous T on cardiovascular mortality or morbidity have not been extensively investigated in prospective controlled studies; preliminary data suggest there may be short-term improvements in electrocardiographic changes in men with coronary artery disease. In the majority of animal experiments, exogenous T exerts either neutral or beneficial effects on the development of atherosclerosis. Exogenous androgens induce both apparently beneficial and deleterious effects on cardiovascular risk factors by decreasing serum levels of HDL-C, plasminogen activator type 1 (apparently deleterious), lipoprotein (a), fibrinogen, insulin, leptin, and visceral fat mass (apparently beneficial) in men as well as women. However, androgen-induced declines in circulating HDL-C should not automatically be assumed to be proatherogenic, because these declines may instead reflect accelerated reverse cholesterol transport. Supraphysiological concentrations of T stimulate vasorelaxation; but at physiological concentrations, beneficial, neutral, and detrimental effects on vascular reactivity have been observed. T exerts proatherogenic effects on macrophage function by facilitating the uptake of modified lipoproteins and an antiatherogenic effect by stimulating efflux of cellular cholesterol to HDL. In conclusion, the inconsistent data, which can only be partly explained by differences in dose and source of androgens, militate against a meaningful assessment of the net effect of T on atherosclerosis. Based on current evidence, the therapeutic use of T in men need not be restricted by concerns regarding cardiovascular side effects. Available data also do not justify the uncontrolled use of T or dehydroepiandrosterone for the prevention or treatment of coronary heart disease.
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Affiliation(s)
- Fredrick C W Wu
- Department of Endocrinology, Manchester Royal Infirmary, University of Manchester, Manchester M13 9WL, United Kingdom.
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Vrbíková J, Tallová J, Biciková M, Dvoráková K, Hill M, Stárka L. Plasma thiols and androgen levels in polycystic ovary syndrome. Clin Chem Lab Med 2003; 41:216-21. [PMID: 12667010 DOI: 10.1515/cclm.2003.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Homocysteine is a risk factor for ischemic heart disease; similarly as is hyperlipidemia or insulin resistance, which frequently occur in women with polycystic ovary syndrome. We examined the relationships between thiols and hormonal status or insulin resistance in 40 women (aged 25.8 +/- 7 years) with polycystic ovary syndrome and in 11 controls (33 +/- 5 years). Blood levels of homocysteine, glutathione, total and high density lipoprotein (HDL)-cholesterol, triglycerides, insulin, sex hormone-binding globulin, testosterone, androstenedione, dehydroepiandrosterone sulfate, and estradiol were determined. Student's t test and Spearman correlations were computed after adjustment for body mass index (BMI) and age. Homocysteine was significantly higher in polycystic ovary syndrome patients than in the control group (10.3 +/- 2.87 vs. 8.78 +/- 2.75 micromol/l; p < 0.05). In women with polycystic ovary syndrome, there were significant positive correlations between homocysteine and androstenedione (r = 0.329; p < 0.05) and glutathione and dehydroepiandrosterone sulfate (DHEA-S) (r = 0.469; p < 0.05). We conclude that homocysteine is increased in women with polycystic ovary syndrome and is probably linked to androgen levels but not to markers of insulin resistance or with lipid metabolism.
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Affiliation(s)
- Jana Vrbíková
- Institute of Endocrinology, Prague 1, Prague, Czech Republic.
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Abstract
In the process of atherosclerosis sex steroids play a complex role in the vascular vessel wall system. Although a number of experimental studies have clearly documented an atheroprotective effect of estrogens, in recent clinical studies, estrogen replacement therapy has failed to reduce cardiovascular mortality. The effects of androgens on the cardiovascular system and cardiovascular diseases are even more controversial. Whereas in the past, androgens were mainly believed to exert adverse effects on the cardiovascular system, recent studies in men have documented a number of beneficial actions of testosterone in the arterial vascular system. Androgens affect lipid metabolism (e.g., LDL and HDL cholesterol, Lp(a)) and hemostasis (e.g., platelet aggregation and fibrinolytic activity). In addition, several other physiological and pathophysiological processes in the arterial vessel wall are influenced by androgens. Acute hemodynamic effects of testosterone on coronary vasomotion and stress-test-induced ischemia were reported. Additionally, recent animal and in vitro studies have further documented an inhibitory effect of androgens on neointimal plaque formation. This review discusses different and, in part, contradictory effects of androgens on the cardiovascular system including potential signal transduction pathways in androgen target cells.
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Affiliation(s)
- Wolfgang Weidemann
- Department of General Zoology and Endocrinology, University of Ulm, Albert-Einstein-Allee 11, 89069 Ulm, Germany.
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Ravaglia G, Forti P, Maioli F, Sacchetti L, Nativio V, Scali CR, Mariani E, Zanardi V, Stefanini A, Macini PL. Dehydroepiandrosterone-sulfate serum levels and common age-related diseases: results from a cross-sectional Italian study of a general elderly population. Exp Gerontol 2002; 37:701-12. [PMID: 11909687 DOI: 10.1016/s0531-5565(01)00232-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The association of low serum dehydroepiandrosterone sulfate (DHEAS) levels with age, lifestyle, general health status indicators, and specific diseases was investigated in 436 men and 544 women of 65-97 yr old. In both sexes low serum DHEAS levels were associated with age, alcohol intake, number of current medications, and decreased thyroid function. Low DHEAS was also associated with low serum albumin in men and low systolic blood pressure in women. Compared to healthy men (n=106) age-adjusted serum DHEAS levels were significantly lower in men with atrial fibrillation, chronic obstructive lung disease, dementia, parkinsonism, cancer, diabetes, hypothyroidism, and in institutionalized men. Compared to healthy women (n=100) age-adjusted serum DHEAS levels were significantly lower in women with occlusive arterial disease, chronic obstructive lung disease, and osteoporosis. After controlling for differences in lifestyle and general health status parameters, low DHEAS levels remained statistically associated only with atrial fibrillation in men and osteoporosis in women, and it cannot be excluded that these association were spurious, due to multiple comparisons. These data suggest that in elderly people low serum DHEAS levels are more a non-specific indicator of aging and health status than a risk indicator of specific diseases.
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Affiliation(s)
- Giovanni Ravaglia
- Department of Internal Medicine, Cardioangiology, and Hepatology, University Hospital S. Orsola-Malpighi, Via Massarenti, 9, Bologna, Italy.
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