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Wang Q, Mesaros C. Advances and challenges in liquid chromatography-spectrometry (LC-MS) methodology for quantifying androgens and estrogens in human serum and plasma. J Steroid Biochem Mol Biol 2024; 245:106618. [PMID: 39313162 DOI: 10.1016/j.jsbmb.2024.106618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 09/04/2024] [Accepted: 09/05/2024] [Indexed: 09/25/2024]
Abstract
Accurate quantification of androgens and estrogens is critical for elucidating their roles in endocrine disorders and advancing research on their functions in human biology and pathophysiology. This review highlights recent advances and ongoing challenges in liquid chromatography- mass spectrometry (LC- MS) methodology for quantifying androgens and estrogens in human serum and plasma. We summarized current approaches for analyzing the different forms of androgens and estrogens, along with their reported levels in publications from 2010 to the present. These published levels pointed out the inconsistencies in reference intervals across studies. To address these issues, advances in derivatization methods and chromatographic separation techniques are reviewed. Future perspectives for improving the accuracy and consistency of hormone quantification in clinical and research settings were also proposed.
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Affiliation(s)
- Qingqing Wang
- Center for Excellence in Environmental Toxicology, Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Clementina Mesaros
- Center for Excellence in Environmental Toxicology, Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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2
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Mauvais-Jarvis F, Lindsey SH. Metabolic benefits afforded by estradiol and testosterone in both sexes: clinical considerations. J Clin Invest 2024; 134:e180073. [PMID: 39225098 PMCID: PMC11364390 DOI: 10.1172/jci180073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
Abstract
Testosterone (T) and 17β-estradiol (E2) are produced in male and female humans and are potent metabolic regulators in both sexes. When E2 and T production stops or decreases during aging, metabolic dysfunction develops and promotes degenerative metabolic and vascular disease. Here, we discuss the shared benefits afforded by E2 and T for metabolic function human females and males. In females, E2 is central to bone and vascular health, subcutaneous adipose tissue distribution, skeletal muscle insulin sensitivity, antiinflammatory immune function, and mitochondrial health. However, T also plays a role in female skeletal, vascular, and metabolic health. In males, T's conversion to E2 is fundamental to bone and vascular health, as well as prevention of excess visceral adiposity and the promotion of insulin sensitivity via activation of the estrogen receptors. However, T and its metabolite dihydrotestosterone also prevent excess visceral adiposity and promote skeletal muscle growth and insulin sensitivity via activation of the androgen receptor. In conclusion, T and E2 are produced in both sexes at sex-specific concentrations and provide similar and potent metabolic benefits. Optimizing levels of both hormones may be beneficial to protect patients from cardiometabolic disease and frailty during aging, which requires further study.
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Affiliation(s)
- Franck Mauvais-Jarvis
- Medicine Service, Section of Endocrinology, Hormone Therapy Clinic, Southeast Louisiana VA Medical Center, New Orleans, Louisiana, USA
- Deming Department of Medicine, Section of Endocrinology and Metabolism, Tulane University School of Medicine, New Orleans, Louisiana, USA
- Tulane Center of Excellence in Sex-Based Biology & Medicine, New Orleans, Louisiana, USA
| | - Sarah H. Lindsey
- Tulane Center of Excellence in Sex-Based Biology & Medicine, New Orleans, Louisiana, USA
- Department of Pharmacology, Tulane University School of Medicine, New Orleans, Louisiana, USA
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3
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Raps M, Kleider C, Lehmann L. Quantitative analysis of 34 sex (pro)hormones, conjugates and bioactive oxidation products thereof in human plasma by GC- and LC-MS/MS and systematic investigation of overestimations of analyte concentrations not accounted for by method validation. Steroids 2024; 208:109441. [PMID: 38768743 DOI: 10.1016/j.steroids.2024.109441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/22/2024]
Abstract
When investigating endocrine disorders, it is essential to assess a comprehensive quantitative profile of sex (pro)hormones in plasma including conjugates. Thus, the present study aimed to develop and validate a comprehensive mass spectrometry-based multimethod combining the direct analysis of unconjugated sex (pro)hormones and oxidation products thereof (by GC), as well as their sulfates and glucuronides present in higher concentrations (by LC) with the indirect quantification of glucuronides present in lower concentrations after selective glucuronide hydrolysis (by GC) and its application to plasma derived from ten pre- and postmenopausal women and men each. Even guideline-compliant validation experiments cannot completely reflect overestimation of analyte concentrations due to effects depending on the individual ratio of analytes (i.e. chemical formation of analytes or incomplete removal of interfering analytes). Thus, the extent of processes not accounted for by the calibration strategy were investigated and maximum over- or underestimations of analyte concentrations were assessed for each plasma sample individually. 34 analytes were successfully calibrated, validated (median accuracy 101.1 %, median inter-day precision 8.1 %) and 31 were detected above the detection limit in plasma samples. The sporadic maximum individual over- or underestimation of analyte concentrations amounted to less than 20 %.
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Affiliation(s)
- Miriam Raps
- University of Würzburg, Chair of Food Chemistry, 97074 Würzburg, Germany.
| | - Carolin Kleider
- University of Würzburg, Chair of Food Chemistry, 97074 Würzburg, Germany.
| | - Leane Lehmann
- University of Würzburg, Chair of Food Chemistry, 97074 Würzburg, Germany.
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Davis SR, Azene ZN, Tonkin AM, Woods RL, McNeil JJ, Islam RM. Higher testosterone is associated with higher HDL-cholesterol and lower triglyceride concentrations in older women: an observational study. Climacteric 2024; 27:282-288. [PMID: 38345304 PMCID: PMC11196127 DOI: 10.1080/13697137.2024.2310530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/20/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE This study aimed to determine whether concentrations of testosterone and its main precursor after menopause, dehydroepiandrosterone (DHEA), are associated with lipoproteins and other lipids in community-dwelling older women. METHODS The Sex Hormones in Older Women (SHOW) study was an observational study of 6358 Australian women, aged at least 70 years, with no prior major adverse cardiovascular event who had sex hormones measured by liquid chromatography-tandem mass spectrometry. Associations between hormones and lipids were examined using multilinear regression adjusted for potential confounders. RESULTS The cross-sectional analyses included 3231 participants, median age 74.0 (interquartile range 71.7-77.9) years. Compared with concentrations in the lowest quartile (Q1), testosterone concentrations in the highest quartiles (Q3 and Q4) were positively associated with high-density lipoprotein cholesterol (HDL-C) (p = 0.002 and p < 0.001, respectively) while Q4 testosterone concentrations were positively associated with total cholesterol (p = 0.038). Q2, Q3 and Q4 testosterone concentrations were significantly inversely associated with triglycerides (TG) (p = 0.024, p = 0.003 and p < 0.001, respectively). For DHEA, Q4 concentrations was positively associated with non-HDL-C (p = 0.024). CONCLUSIONS In older women, higher endogenous testosterone concentrations are significantly associated with higher HDL-C and lower TG, indicating a less atherogenic profile. These findings suggest a neutral, or potentially protective, cardiovascular disease effect of testosterone in older women.
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Affiliation(s)
- Susan R Davis
- Women’s Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia 3004
- Department of Endocrinology and Diabetes, Alfred Health, Melbourne, Victoria Australia 3004
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia 3004
| | - Zelalem N Azene
- Women’s Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia 3004
| | - Andrew M Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia 3004
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia 3004
| | - John J McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia 3004
| | - Rakibul M Islam
- Women’s Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia 3004
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia 3004
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5
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Davis SR. Testosterone and the heart: friend or foe? Climacteric 2024; 27:53-59. [PMID: 37666273 DOI: 10.1080/13697137.2023.2250252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/24/2023] [Accepted: 08/16/2023] [Indexed: 09/06/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death in women aged 65 years and older. Sex hormones have been implicated as having a critical role in the evolution of CVD, with the focus mainly on estrogens in women. Available data also indicate that low testosterone blood levels may be detrimental to cardiovascular function in women. At blood concentrations considered normal for premenopausal women, testosterone has favorable effects on blood vessel function (relaxation and contraction), much of which is determined by the endothelial cells that line the inside of blood vessels. Testosterone enhances endothelium-dependent and independent brachial artery vasodilation and has an acute systolic blood pressure-lowering effect in postmenopausal women. Advantageous effects of testosterone in animal models have been seen for myocardial function and cardiac electrical signaling. Human data are mainly limited to observational and mechanistic studies, which mostly demonstrate beneficial effects of testosterone on cardiovascular health. Few studies of testosterone use in women, with cardiovascular endpoints as primary outcomes, have been published.
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Affiliation(s)
- S R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Endocrinology and Diabetes, Alfred Health, Melbourne, VIC, Australia
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Renke G, Tostes F. Cardiovascular Safety and Benefits of Testosterone Implant Therapy in Postmenopausal Women: Where Are We? Pharmaceuticals (Basel) 2023; 16:ph16040619. [PMID: 37111376 PMCID: PMC10146246 DOI: 10.3390/ph16040619] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/14/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
We discuss the CV safety and efficacy data for subcutaneous testosterone therapy (STT) in postmenopausal women. We also highlight new directions and applications of correct dosages performed in a specialized center. To recommend STT, we propose innovative criteria (IDEALSTT) according to total testosterone (T) level, carotid artery intima-media thickness, and calculated SCORE for a 10-year risk of fatal cardiovascular disease (CVD). Despite all the controversies, hormone replacement therapy (HRT) with T has gained prominence in treating pre and postmenopausal women in the last decades. HRT with silastic and bioabsorbable testosterone hormone implants has gained prominence recently due to its practicality and effectiveness in treating menopausal symptoms and hypoactive sexual desire disorder. A recent publication on the complications of STT, looking at a large cohort of patients over seven years, demonstrated its long-term safety. However, the cardiovascular (CV) risk and safety of STT in women are still controversial.
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Affiliation(s)
- Guilherme Renke
- Nutrindo Ideais Performance and Nutrition Research Center, Rio de Janeiro 22411-040, Brazil
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro 21941-617, Brazil
| | - Francisco Tostes
- Nutrindo Ideais Performance and Nutrition Research Center, Rio de Janeiro 22411-040, Brazil
- Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro 21941-617, Brazil
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The Role of Certain Polymorphic Variants in Genes, Previously Associated with Blood Pressure Values, with Reference to the Risk of Development of Coronary Artery Disease. ACTA MEDICA BULGARICA 2022. [DOI: 10.2478/amb-2022-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
Abstract
The aim of the study was to analyze the effect of polymorphic variants previously associated with arterial hypertension (AH) in Genome Wide Association Studies (GWASs) in/next to genes and locuses CYP7A1 and PLEKHA7 on the development of coronary artery disease (CAD) in Bulgarian patients. A hundred and nine consecutive patients with angiographically documented CAD were studied. The genotyping was done with 7900 HT Fast Real-Time PCR (Applied Biosystems) with TaqMan® method. The control group consisted of 192 healthy population controls, selected from the bio- bank of the Molecular Medicine Center. SPSS and PLINK were used for the statistical analysis with level of significance < 0.05 and confidence interval 95%. The mean age of the studied patients was 63.71 ± 9.35 years; 35 (35%) females. Previous myocardial infarction (MI) had 38(38%); one-vessel – 39 (39%); two-vessel – 28 (28%); three-vessel disease – 34 (34%); 43 (43%) were with diabetes mellitus; 92 (92%) – with arterial hypertension (AH); 77 (77%) – with dyslipidemia; 42 (42%) were smokers; 25 (25%) were obese. We did not find any significant association between CAD and poly- morphism rs11191548 near CYP17A1 and only a tendency for genotype of rs381815 in PLEKHA7 (p = 0.06; OR 0.64; CI 0.40-1.02 for CAD) under dominant model. This is of practical importance both for studying the genetic aspects of CAD in the future and for enlargement of the current database.
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Zhao Y, Gao YT, Zhang X, Rockwood AL, Kushnir MM, Cai Q, Wu J, Shi J, Lan Q, Rothman N, Shyr Y, Shu XO, Zheng W, Yang G. Endogenous sex hormones, aromatase activity and lung cancer risk in postmenopausal never-smoking women. Int J Cancer 2022; 151:699-707. [PMID: 35338778 PMCID: PMC9271581 DOI: 10.1002/ijc.34005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 02/23/2022] [Accepted: 03/14/2022] [Indexed: 11/09/2022]
Abstract
Although reproductive factors have been repeatedly associated with lung cancer risk, no study to date has directly evaluated the relationship with endogenous sex hormones nor with aromatase activity in postmenopausal never-smoking women. A case-control study of 397 incident lung cancer cases and their individually matched controls, nested within the Shanghai Women's Health Study, was conducted among postmenopausal women who were lifetime never smokers. Prediagnostic concentrations of sex hormones was quantitated using LC-MS/MS assays in plasma. The product-substrate molar ratio of estrone to androstenedione was used as an index of aromatase activity (IAA). Multivariable conditional logistic regression models were used to calculate odds ratios (ORs) for lung cancer. Baseline concentrations of estradiol, free testosterone and IAA were inversely associated with subsequent risk of lung cancer in multivariable-adjusted models. When further adjusted for body mass index, the inverse association with estradiol was attenuated and no longer statistically significant, but the association with free testosterone and IAA remained. In analyses confined to participants having never used menopausal hormone therapy in 376 case-control pairs, the inverse association with free testosterone and IAA was slightly strengthened. OR for the highest vs the lowest quartile of free testosterone was 0.55 (95% CI = 0.34-0.90; Ptrend = .03), and the corresponding OR for IAA was 0.57 (95% CI = 0.34-0.96; Ptrend = .04). Our study, for the first time, suggests that higher levels of circulating free testosterone and estimated aromatase activity may be associated with lower lung cancer risk in postmenopausal never-smoking women.
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Affiliation(s)
- Yingya Zhao
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Yu-Tang Gao
- Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | - Alan L Rockwood
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Mark M Kushnir
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT, USA
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Jie Wu
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Jiajun Shi
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Yu Shyr
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
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9
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Islam RM, Bell RJ, Handelsman DJ, McNeil JJ, Nelson MR, Reid CM, Tonkin AM, Wolfe RS, Woods RL, Davis SR. Associations between blood sex steroid concentrations and risk of major adverse cardiovascular events in healthy older women in Australia: a prospective cohort substudy of the ASPREE trial. THE LANCET. HEALTHY LONGEVITY 2022; 3:e109-e118. [PMID: 35252940 PMCID: PMC8896500 DOI: 10.1016/s2666-7568(22)00001-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Blood testosterone concentrations in women decline during the reproductive years and reach a nadir in the seventh decade, after which concentrations increase and are restored to those of reproductive-aged women early in the eighth decade. We aimed to establish the association between the concentration of testosterone in the blood and risk of major adverse cardiovascular events (MACE) and all-cause mortality in healthy older women. METHODS SHOW was a prospective cohort substudy of the longitudinal randomised ASPREE trial. Eligible participants were women aged at least 70 years from Australia with unimpaired cognition, no previous MACE, and a life expectancy of at least 5 years. Participants who were receiving hormonal or steroid therapy were ineligible for inclusion. We measured serum concentrations of sex steroids with liquid chromatography-tandem mass spectrometry and of SHBG with immunoassay. We compared lower concentrations of sex hormones with higher concentrations using four quartiles. Primary endpoints were risk of MACE and all-cause mortality, the associations of which with sex steroid concentrations were assessed using Cox proportional hazards regression that included age, body-mass index, smoking status, alcohol consumption, diabetes, hypertension, dyslipidaemia, impaired renal function, and treatment allocation in the ASPREE trial (aspirin vs placebo). ASPREE is registered with ClinicalTrials.gov, NCT01038583. FINDINGS Of the 9180 women recruited to the ASPREE trial between March 10, 2010, and Dec 31 2014, 6358 participants provided sufficient biobank samples at baseline and 5535 were included in the final analysis. Median age at entry was 74·0 years (IQR 71·7-77·7). During a median 4·4 years of follow-up (24 553 person-years), 144 (2·6%) women had a first MACE (incidence 5·9 per 1000 person-years). During a median 4·6 years of follow-up (3·8-5·6), 200 women died (7·9 per 1000 person-years). In the fully adjusted models, higher concentrations of testosterone were associated with a lower incidence of MACE (quartile 4 vs quartile 1: hazard ratio 0·57 [95% CI 0·36-0·91]; p=0·02), as were higher concentrations of DHEA (quartile 4 vs quartile 1: 0·61 [0·38-0·97]; p=0·04). For oestrone, a lower risk of MACE was seen for concentrations in quartile 2 only, compared with quartile 1 (0·55 [0·33-0·92]; p=0·02). In fully adjusted models, no association was seen between SHBG and MACE, or between any hormone or SHBG and all-cause mortality. INTERPRETATION Blood concentrations of testosterone and DHEA above the lowest quartile in older women were associated with a reduced risk of a first-ever MACE. Given that the physiological effects of DHEA are mediated through its steroid metabolites, if the current findings were to be replicated, trials investigating testosterone therapy for the primary prevention of ischaemic cardiovascular disease events in older women would be warranted. FUNDING The National Health and Medical Research Council of Australia, US National Institute on Aging, the Victorian Cancer Agency, the Commonwealth Scientific and Industrial Research Organisation, and Monash University.
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Affiliation(s)
- Rakibul M Islam
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (R M Islam PhD, Prof R J Bell MBBS, Prof J J McNeil MBBS, Prof M R Nelson MBBS, Prof C M Reid PhD, Prof R S Wolfe PhD, R L Woods PhD, Prof S R Davis MBBS); ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia (Prof D J Handelsman MBBS); Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (Prof M R Nelson); School of Population Health, Curtin University, Bentley, WA, Australia (Prof C M Reid)
| | - Robin J Bell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (R M Islam PhD, Prof R J Bell MBBS, Prof J J McNeil MBBS, Prof M R Nelson MBBS, Prof C M Reid PhD, Prof R S Wolfe PhD, R L Woods PhD, Prof S R Davis MBBS); ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia (Prof D J Handelsman MBBS); Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (Prof M R Nelson); School of Population Health, Curtin University, Bentley, WA, Australia (Prof C M Reid)
| | - David J Handelsman
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (R M Islam PhD, Prof R J Bell MBBS, Prof J J McNeil MBBS, Prof M R Nelson MBBS, Prof C M Reid PhD, Prof R S Wolfe PhD, R L Woods PhD, Prof S R Davis MBBS); ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia (Prof D J Handelsman MBBS); Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (Prof M R Nelson); School of Population Health, Curtin University, Bentley, WA, Australia (Prof C M Reid)
| | - John J McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (R M Islam PhD, Prof R J Bell MBBS, Prof J J McNeil MBBS, Prof M R Nelson MBBS, Prof C M Reid PhD, Prof R S Wolfe PhD, R L Woods PhD, Prof S R Davis MBBS); ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia (Prof D J Handelsman MBBS); Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (Prof M R Nelson); School of Population Health, Curtin University, Bentley, WA, Australia (Prof C M Reid)
| | - Mark R Nelson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (R M Islam PhD, Prof R J Bell MBBS, Prof J J McNeil MBBS, Prof M R Nelson MBBS, Prof C M Reid PhD, Prof R S Wolfe PhD, R L Woods PhD, Prof S R Davis MBBS); ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia (Prof D J Handelsman MBBS); Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (Prof M R Nelson); School of Population Health, Curtin University, Bentley, WA, Australia (Prof C M Reid)
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (R M Islam PhD, Prof R J Bell MBBS, Prof J J McNeil MBBS, Prof M R Nelson MBBS, Prof C M Reid PhD, Prof R S Wolfe PhD, R L Woods PhD, Prof S R Davis MBBS); ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia (Prof D J Handelsman MBBS); Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (Prof M R Nelson); School of Population Health, Curtin University, Bentley, WA, Australia (Prof C M Reid)
| | - Andrew M Tonkin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (R M Islam PhD, Prof R J Bell MBBS, Prof J J McNeil MBBS, Prof M R Nelson MBBS, Prof C M Reid PhD, Prof R S Wolfe PhD, R L Woods PhD, Prof S R Davis MBBS); ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia (Prof D J Handelsman MBBS); Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (Prof M R Nelson); School of Population Health, Curtin University, Bentley, WA, Australia (Prof C M Reid)
| | - Rory S Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (R M Islam PhD, Prof R J Bell MBBS, Prof J J McNeil MBBS, Prof M R Nelson MBBS, Prof C M Reid PhD, Prof R S Wolfe PhD, R L Woods PhD, Prof S R Davis MBBS); ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia (Prof D J Handelsman MBBS); Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (Prof M R Nelson); School of Population Health, Curtin University, Bentley, WA, Australia (Prof C M Reid)
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (R M Islam PhD, Prof R J Bell MBBS, Prof J J McNeil MBBS, Prof M R Nelson MBBS, Prof C M Reid PhD, Prof R S Wolfe PhD, R L Woods PhD, Prof S R Davis MBBS); ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia (Prof D J Handelsman MBBS); Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (Prof M R Nelson); School of Population Health, Curtin University, Bentley, WA, Australia (Prof C M Reid)
| | - Susan R Davis
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia (R M Islam PhD, Prof R J Bell MBBS, Prof J J McNeil MBBS, Prof M R Nelson MBBS, Prof C M Reid PhD, Prof R S Wolfe PhD, R L Woods PhD, Prof S R Davis MBBS); ANZAC Research Institute, University of Sydney, Sydney, NSW, Australia (Prof D J Handelsman MBBS); Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia (Prof M R Nelson); School of Population Health, Curtin University, Bentley, WA, Australia (Prof C M Reid)
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10
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Bianchi VE, Bresciani E, Meanti R, Rizzi L, Omeljaniuk RJ, Torsello A. The role of androgens in women's health and wellbeing. Pharmacol Res 2021; 171:105758. [PMID: 34242799 DOI: 10.1016/j.phrs.2021.105758] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 12/29/2022]
Abstract
Androgens in women, as well as in men, are intrinsic to maintenance of (i) reproductive competency, (ii) cardiac health, (iii) appropriate bone remodeling and mass retention, (iii) muscle tone and mass, and (iv) brain function, in part, through their mitigation of neurodegenerative disease effects. In recognition of the pluripotency of endogenous androgens, exogenous androgens, and selected congeners, have been prescribed off-label for several decades to treat low libido and sexual dysfunction in menopausal women, as well as, to improve physical performance. However, long-term safety and efficacy of androgen administration has yet to be fully elucidated. Side effects often observed include (i) hirsutism, (ii) acne, (iii) deepening of the voice, and (iv) weight gain but are associated most frequently with supra-physiological doses. By contrast, short-term clinical trials suggest that the use of low-dose testosterone therapy in women appears to be effective, safe and economical. There are, however, few clinical studies, which have focused on effects of androgen therapy on pre- and post-menopausal women; moreover, androgen mechanisms of action have not yet been thoroughly explained in these subjects. This review considers clinical effects of androgens on women's health in order to prevent chronic diseases and reduce cancer risk in gynecological tissues.
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Affiliation(s)
- Vittorio E Bianchi
- Endocrinology and Metabolism, Clinical Center Stella Maris, Strada Rovereta 42, Falciano 47891, San Marino.
| | - Elena Bresciani
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy.
| | - Ramona Meanti
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy.
| | - Laura Rizzi
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy.
| | - Robert J Omeljaniuk
- Department of Biology, Lakehead University, 955 Oliver Rd, Thunder Bay, Ontario P7B 5E1, Canada.
| | - Antonio Torsello
- School of Medicine and Surgery, University of Milano-Bicocca, Via Cadore 48, Monza 20900, Italy.
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11
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Penell JC, Kushnir MM, Lind L, Bergquist J, Bergquist J, Lind PM, Naessen T. Concentrations of nine endogenous steroid hormones in 70-year-old men and women. Endocr Connect 2021; 10:511-520. [PMID: 33878730 PMCID: PMC8183619 DOI: 10.1530/ec-21-0045] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/16/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Circulating concentrations of endogenous steroids have systemic implications on health in elderly. However, population-based age- and ethnicity-specific data are scarce. The aim was to report sex-specific plasma concentrations of endogenous sex and adrenal steroids in elderly Swedish Caucasians, to examine the impact of BMI and to present concentrations in apparently healthy subjects. METHODS A population-based observational study of 70-year olds, including 684 community-dwelling men and women enrolled in the PIVUS study, Sweden. Median plasma concentrations were determined using liquid chromatography-tandem mass spectrometry (LC-MS/MS) for pregnenolone, 17-hydroxypregnenolone, 17-hydroxy-progesterone, 11-deoxycortisol, DHEA, androstenedione, testosterone, estrone and estradiol. RESULTS Plasma concentrations were significantly higher in men (n = 452) than in women (n = 232) for estradiol: median 61.3 pmol/L (95% CI, 11.4, 142.7) vs 18.4 (4.0, 127.3), for estrone: 92.8 (33.3, 206) vs 71.6 (17.8, 209) pmol/L, and for testosterone 13.8 (5.7, 28.0) vs 0.7 (0.2, 2.0) nmol/L. Higher concentrations of estrone and estradiol were observed in obese than non-obese women. Compared to non-obese men, obese men had lower concentrations of testosterone and its precursors: 17-hydroxypregnenolone, 17-hydroxyprogesterone, androstenedione and DHEA. The subgroup of apparently healthy individuals had median values > 20% lower for estrone and estradiol in women but slightly higher for testosterone in both sexes. CONCLUSIONS Concentrations of estradiol, estrone and testosterone were higher in 70-year-old men than in women. BMI associated positively to estradiol and estrone in women and negatively to testosterone in men. Apparently healthy women had lower median concentrations of estradiol and estrone and men had higher median testosterone compared to all individuals.
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Affiliation(s)
- Johanna Christina Penell
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
- Correspondence should be addressed to J C Penell:
| | - Mark M Kushnir
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah, USA
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Jonatan Bergquist
- Department of Chemistry – BMC, Analytical Chemistry, Uppsala University, Uppsala, Sweden
| | - Jonas Bergquist
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Department of Chemistry – BMC, Analytical Chemistry, Uppsala University, Uppsala, Sweden
| | - P Monica Lind
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Tord Naessen
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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12
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Gravitte A, Archibald T, Cobble A, Kennard B, Brown S. Liquid chromatography-mass spectrometry applications for quantification of endogenous sex hormones. Biomed Chromatogr 2020; 35:e5036. [PMID: 33226656 DOI: 10.1002/bmc.5036] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 01/18/2023]
Abstract
Liquid chromatography, coupled with tandem mass spectrometry, presents a powerful tool for the quantification of the sex steroid hormones 17-β estradiol, progesterone and testosterone from biological matrices. The importance of accurate quantification with these hormones, even at endogenous levels, has evolved with our understanding of the role these regulators play in human development, fertility and disease risk and manifestation. Routine monitoring of these analytes can be accomplished by immunoassay techniques, which face limitations on specificity and sensitivity, or using gas chromatography-mass spectrometry. LC-MS/MS is growing in capability and acceptance for clinically relevant quantification of sex steroid hormones in biological matrices and is able to overcome many of the limitations of immunoassays. Analyte specificity has improved through the use of novel derivatizing agents, and sensitivity has been refined through the use of high-resolution chromatography and mass spectrometric technology. This review highlights these innovations, among others, in LC-MS/MS steroid hormone analysis captured in the literature over the last decade.
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Affiliation(s)
- Amy Gravitte
- James H Quillen College of Medicine, East Tennessee State University, Department of Biomedical Sciences, Johnson City, TN, USA
| | - Timothy Archibald
- Bill Gatton College of Pharmacy, East Tennessee State University, Department of Pharmaceutical Sciences, Johnson City, TN, USA
| | - Allison Cobble
- Bill Gatton College of Pharmacy, East Tennessee State University, Department of Pharmaceutical Sciences, Johnson City, TN, USA
| | - Benjamin Kennard
- Bill Gatton College of Pharmacy, East Tennessee State University, Department of Pharmaceutical Sciences, Johnson City, TN, USA
| | - Stacy Brown
- Bill Gatton College of Pharmacy, East Tennessee State University, Department of Pharmaceutical Sciences, Johnson City, TN, USA
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13
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Koch T, Bräuner EV, Busch AS, Hickey M, Juul A. Marked Increase in Incident Gynecomastia: A 20-Year National Registry Study, 1998 to 2017. J Clin Endocrinol Metab 2020; 105:5868100. [PMID: 32754750 DOI: 10.1210/clinem/dgaa440] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/03/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Gynecomastia, the proliferation of mammary glandular tissue in the male, is a frequent but little-studied condition. Available prevalence data are based on selected patient populations or autopsy cases with their inherent bias. OBJECTIVE The objective of this work is to evaluate the age-related incidence and secular trends in gynecomastia in the general population. DESIGN An observational, 20-year national registry study was conducted. SETTING This population-based study used nationwide registry data. PARTICIPANTS Participants included all Danish males (age 0-80 years) with a first-time diagnosis of gynecomastia. MAIN OUTCOME MEASURES All Danish males (age 0-80 years) were followed up for incident diagnosis of gynecomastia in the Danish National Patient Registry from 1998 to 2017 using the International Codes of Diseases, 10th revision, and the Danish Health Care Classification System. Age-specific incidence rates were estimated. The hypothesis tested in this study was formulated prior to data collection. RESULTS Overall, a total 17 601 males (age 0-80 years) were registered with an incident diagnosis of gynecomastia within the 20-year study period, corresponding to 880 new cases per year and an average 20-year incidence of 3.4 per 10 000 men (age 0-80 years). The average annual incidence was 6.5/10 000 in postpubertal males age 16 to 20 years and 4.6/10 000 in males age 61 to 80 years, with a respective 5- and 11-fold overall increase in these 2 age groups over the 20-year period. CONCLUSIONS The incidence of gynecomastia has dramatically increased over the last 20 years, implying that the endogenous or exogenous sex-steroid environment has changed, which is associated with other adverse health consequences in men such as an increased risk of prostate cancer, metabolic syndrome, type 2 diabetes, or cardiovascular disorders.
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Affiliation(s)
- Trine Koch
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Elvira V Bräuner
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Alexander S Busch
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - Anders Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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14
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Development and validation of a UHPLC-HRMS method for the simultaneous determination of the endogenous anabolic androgenic steroids in human serum. J Chromatogr A 2020; 1613:460686. [DOI: 10.1016/j.chroma.2019.460686] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/25/2019] [Accepted: 11/05/2019] [Indexed: 01/01/2023]
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15
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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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16
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Penn CA, Chan J, Mesaros C, Snyder NW, Rader DJ, Sammel MD, Dokras A. Association of serum androgens and coronary artery calcium scores in women. Fertil Steril 2019; 112:586-593. [PMID: 31200968 DOI: 10.1016/j.fertnstert.2019.04.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/27/2019] [Accepted: 04/15/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine the association between serum androgens measured by high-resolution liquid chromatography-mass spectrometry and coronary artery calcium (CAC) scores. DESIGN Cross-sectional study. SETTING Academic institution. PATIENT(S) A total of 239 women, aged 40-75 years, with CAC testing and complete cardiovascular disease risk evaluation. Total T, DHEA, and androstenedione were measured using high-resolution liquid chromatography-mass spectrometry, whereas E2 and sex hormone-binding globulin were measured using commercial assays. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Independent associations between CAC scores and sex steroids. RESULT(S) Overall, 164 subjects had a CAC score < 10, 48 had a CAC score between 10 and 100, and 27 had a score > 100. There were no differences in sex hormone levels between women with CAC scores > 10 vs. CAC scores ≤ 10. In multivariable models adjusting for age, body mass index, and low-density lipoprotein cholesterol, a higher T/E2 ratio was associated with an elevated CAC score, with an unadjusted odds ratio associated with 1-SD change in log-transformed T/E2 of 1.38 (95% confidence interval 1.01-1.89) and adjusted OR 1.02 (95% confidence interval 1.002-1.04). Total T, DHEA, androstenedione, sex hormone-binding globulin, and E2 levels were not associated with increased CAC. CONCLUSION(S) In the general population, there are mixed reports regarding the relationship between serum androgens and risk factors for cardiovascular disease, and limited information on the relationship between androgens and subclinical atherosclerosis. Our study shows that increased androgens relative to estrogens may have a weak but independent association with subclinical atherosclerosis, as measured by CAC scores.
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Affiliation(s)
- Courtney A Penn
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jessica Chan
- Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Clementina Mesaros
- Department of Systems Pharmacology and Translational Therapeutics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nathaniel W Snyder
- A. J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Daniel J Rader
- Institute for Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mary D Sammel
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anuja Dokras
- Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania.
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17
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Liu Q, Chi Q, Fan RT, Tian HD, Wang X. Quantitative-Profiling Method of Serum Steroid Hormones by Hydroxylamine-Derivatization HPLC-MS. NATURAL PRODUCTS AND BIOPROSPECTING 2019; 9:201-208. [PMID: 30968349 PMCID: PMC6538747 DOI: 10.1007/s13659-019-0204-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 04/03/2019] [Indexed: 05/17/2023]
Abstract
A sensitive and rapid high performance liquid chromatography-mass spectrometry (HPLC-MS) method was developed and validated for simultaneous quantification of ten steroid hormones, including estrogens, androgens, progesterones, and corticosteroids four classes of steroids. The following ten steroid hormones were analyzed: progesterone, 21-deoxycortisol, estrone, 4-androstenedione, testosterone, dihydro-testosterone, androstenone, dehydroepiandrosterone, corticosterone and cortisone. Stable deuterated isotopes were used as internal standards for quantification. Sample preparation with and without derivatization were performed after liquid-liquid extraction, and the corresponding results were compared according to sensitivity and selectivity. Hydroxylamine derivatization was found to improve the ionization efficiency of the analytes for electrospray ionization MS analysis. The gradient of mobile phase and experimental parameters for HPLC separation were optimized. The lower limits of quantification were in the range of 0.05-5 ng mL-1 with wide linear range for the ten steroid hormones. The intra-day precision < 11.1% and recovery of 84.5-120% with negligible matrix effect were achieved, where within the acceptance limits of the FDA guideline. Total HPLC-MS analysis time was 6 min. This method enables simultaneous quantification of steroids in human serum. It will be helpful for the serum steroid profiling in order to understand various endocrinology diseases.
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Affiliation(s)
- Qi Liu
- Key Laboratory of Analytical Chemistry of the State Ethnic Affairs Commission, College of Chemistry and Materials Science, South-Central University for Nationalities, Wuhan, 430074, Hubei, People's Republic of China
| | - Quan Chi
- Key Laboratory of Analytical Chemistry of the State Ethnic Affairs Commission, College of Chemistry and Materials Science, South-Central University for Nationalities, Wuhan, 430074, Hubei, People's Republic of China
| | - Ru-Ting Fan
- Key Laboratory of Analytical Chemistry of the State Ethnic Affairs Commission, College of Chemistry and Materials Science, South-Central University for Nationalities, Wuhan, 430074, Hubei, People's Republic of China
| | - Hui-Dong Tian
- Key Laboratory of Analytical Chemistry of the State Ethnic Affairs Commission, College of Chemistry and Materials Science, South-Central University for Nationalities, Wuhan, 430074, Hubei, People's Republic of China
| | - Xian Wang
- Key Laboratory of Analytical Chemistry of the State Ethnic Affairs Commission, College of Chemistry and Materials Science, South-Central University for Nationalities, Wuhan, 430074, Hubei, People's Republic of China.
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18
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Huang Y, Dai W, Li Y. Potential associations of testosterone/estradiol ratio, leukocyte hTERT expression and PBMC telomerase activity with aging and the presence of coronary artery disease in men. Exp Gerontol 2019; 117:38-44. [DOI: 10.1016/j.exger.2018.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 12/26/2022]
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19
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Robeva R, Elenkova A, Zacharieva S. Causes and Metabolic Consequences of Gynecomastia in Adult Patients. Int J Endocrinol 2019; 2019:6718761. [PMID: 31687020 PMCID: PMC6794958 DOI: 10.1155/2019/6718761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/21/2019] [Accepted: 09/06/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Gynecomastia (GM) is a benign enlargement of male breast due to glandular tissue proliferation. GM is a symptom of systemic or local hormonal disturbances, which could be associated with functional changes or pathological conditions. However, the long-lasting steroid imbalance in men with GM might exert negative influence on their metabolic health. METHODS A total of 110 adult men with symptomatic GM were included in the present retrospective cross-sectional study. Anthropometric, metabolic, and hormonal data of the patients were collected. RESULTS In almost 64% of GM patients, the underlying pathological condition was identified. Moreover, the development of GM was among the primary symptoms leading to the proper diagnosis in more than 40% of hypogonadal patients. The prevalence of metabolic syndrome (MS) was 53%; the highest prevalence of MS was found in patients with medication-induced GM and in the hypogonadal patients, whereas the lowest prevalence was observed in men with idiopathic postpubertal GM despite the similar degree of obesity. The lower testosterone levels were associated with more unfavorable lipid profile in the GM patients. CONCLUSION The development of GM in adults might be an important symptom of an underlying gonadal disease. Moreover, it could be associated with an increased risk of metabolic disturbances. Our results support the need of detailed laboratory and hormonal investigations in patients with GM including targeted screening for metabolic disturbances. Further longitudinal studies are needed to evaluate the long-term consequences of sex hormones imbalance on cardiovascular morbidity and mortality in adults with GM.
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Affiliation(s)
- Ralitsa Robeva
- USHATE “Acad. Iv. Penchev”, Department of Endocrinology, Faculty of Medicine, Medical University-Sofia, Sofia, Bulgaria
| | - Atanaska Elenkova
- USHATE “Acad. Iv. Penchev”, Department of Endocrinology, Faculty of Medicine, Medical University-Sofia, Sofia, Bulgaria
| | - Sabina Zacharieva
- USHATE “Acad. Iv. Penchev”, Department of Endocrinology, Faculty of Medicine, Medical University-Sofia, Sofia, Bulgaria
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20
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El Khoudary SR, Thurston RC. Cardiovascular Implications of the Menopause Transition: Endogenous Sex Hormones and Vasomotor Symptoms. Obstet Gynecol Clin North Am 2018; 45:641-661. [PMID: 30401548 DOI: 10.1016/j.ogc.2018.07.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The menopause transition (MT) is a critical period of women's lives marked by several physiologic changes and menopause-related symptoms that have implications for health. Risk for cardiovascular disease, the leading cause of death in women, increases after menopause, suggesting a contribution of the MT to its development. This article focuses on the relationship between 2 main features of the MT and women's cardiovascular health: (1) dynamic alterations of sex hormones, particularly endogenous estradiol and follicle-stimulating hormone, and (2) vasomotor symptoms, the cardinal symptom of the menopause. Limitations and future directions are discussed.
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Affiliation(s)
- Samar R El Khoudary
- Department of Epidemiology, Graduate School of Public Health, Epidemiology Data Center, University of Pittsburgh, 4420 Bayard Street, Suite 600, Pittsburgh, PA 15260, USA.
| | - Rebecca C Thurston
- Departments of Psychiatry and Epidemiology, School of Medicine, Graduate School of Public Health, University of Pittsburgh, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
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21
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Lundström E, Carlström K, Naessen S, Söderqvist G. Dehydroepiandrosterone and/or its metabolites: possible androgen receptor antagonistic effects on digitized mammographic breast density in normal breast tissue of postmenopausal women. Horm Mol Biol Clin Investig 2018; 35:/j/hmbci.ahead-of-print/hmbci-2018-0036/hmbci-2018-0036.xml. [PMID: 30144382 DOI: 10.1515/hmbci-2018-0036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 07/02/2018] [Indexed: 11/15/2022]
Abstract
Background Androgens, notably testosterone inhibit breast cell proliferation and negative correlations between free testosterone (fT) and breast cell proliferation as well as mammographic density have been described. Dehydroepiandrosterone (DHEA) is reported to be a partial androgen antagonist in breast tumor cells in vitro. Our aim was to investigate if circulating DHEA had any effects on the association between circulating fT and mammographic density in vivo in the normal postmenopausal breast. Methods We measured visual and digitized mammographic density and serum DHEA, testosterone, sex-hormone-binding globulin and calculated fT in 84 healthy untreated postmenopausal women. Results Significant negative correlations between fT and both visual and digitized mammographic density were strengthened when the median DHEA level decreased from 10.2 to 8.6 nmol/L. Thereafter, correlations became weaker again probably due to decreasing fT levels and/or sample size. There were no correlations between mammographic density and DHEA, at any of the DHEA concentration ranges studied. Serum levels of fT and DHEA were positively correlated. Conclusion Our findings demonstrate that circulating DHEA and/or its metabolites counteract the inhibitory action of fT on mammographic breast density.
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Affiliation(s)
- Eva Lundström
- Division for Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Kjell Carlström
- Division for Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Sabine Naessen
- Division for Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, SE-171 76 Stockholm, Sweden
| | - Gunnar Söderqvist
- Division for Obstetrics and Gynecology, Department of Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, SE-171 76 Stockholm, Sweden, Phone: +46 8 517 700 00, Fax: +46 8 318114
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22
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Abstract
There is significant interest in the use of androgen therapy for postmenopausal women. This review provides background on endogenous androgens in women, describes factors that affect circulating androgen concentrations, and examines the relationship between low levels of androgens and sexual problems. Possible effects of androgens in postmenopausal women beyond sexual function also are discussed. Clinical trials of androgen therapy for the treatment of hypoactive sexual desire disorder are reviewed, with a discussion of potential risks. A practical approach to using androgens to treat low sexual desire with associated distress is presented, accompanied by an illustrative case.
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23
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O'Neal WT, Nazarian S, Alonso A, Heckbert SR, Vaccarino V, Soliman EZ. Sex hormones and the risk of atrial fibrillation: The Multi-Ethnic Study of Atherosclerosis (MESA). Endocrine 2017; 58:91-96. [PMID: 28786078 PMCID: PMC5693706 DOI: 10.1007/s12020-017-1385-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 07/24/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE Atrial fibrillation is more prevalent in men than women. Due to these sex differences in atrial fibrillation susceptibility, we examined whether sex hormones have differing associations with atrial fibrillation risk in men and women. METHODS This analysis included 4883 (mean age = 63 ± 10 years; 39% women; 64% non-white) participants from the Multi-Ethnic Study of Atherosclerosis. Sex hormones (total testosterone, bioavailable testosterone, estradiol, and sex hormone binding globulin) were measured at baseline (2000-2002) for all male and all postmenopausal female participants. Atrial fibrillation was ascertained by hospital discharge records, Medicare claims data, and study electrocardiograms through December 31, 2012. RESULTS Over a median follow-up of 10.9 years, a total of 613 (13%) atrial fibrillation cases were detected. A higher incidence rate of atrial fibrillation was observed for males (n = 385, age-standardized incidence rate per 1000 person-years = 12.3, 95%CI = 11.1, 13.6) than females (n = 228, age-standardized incidence rate per 1000 person-years = 9.0, 95%CI = 7.9, 10.3). In men, higher bioavailable testosterone levels were associated with increased atrial fibrillation risk (HR = 1.32, 95%CI = 1.01, 1.74; p = 0.044; comparing 3rd to 1st tertile), while an association in the opposite direction was observed for women (HR = 0.81, 95%CI = 0.58, 1.13; p = 0.22; comparing 3rd to 1st tertile). Other hormones were not associated with atrial fibrillation in men or women. CONCLUSION Higher levels of endogenous bioavailable testosterone contribute to atrial fibrillation development in men. The combination of endogenous bioavailable testosterone and other risk factors potentially are important for atrial fibrillation development in men.
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Affiliation(s)
- Wesley T O'Neal
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Saman Nazarian
- Department of Medicine, Division of Cardiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Susan R Heckbert
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Viola Vaccarino
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Elsayed Z Soliman
- Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
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24
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El Khoudary SR. Gaps, limitations and new insights on endogenous estrogen and follicle stimulating hormone as related to risk of cardiovascular disease in women traversing the menopause: A narrative review. Maturitas 2017; 104:44-53. [PMID: 28923176 DOI: 10.1016/j.maturitas.2017.08.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/03/2017] [Accepted: 08/04/2017] [Indexed: 02/07/2023]
Abstract
While it is known that estrogen protects heart health in women prior to menopause, its role after menopause and during the menopause transition is far less apparent. Previous reviews summarizing the literature on the impact of endogenous estrogen on risk of cardiovascular disease (CVD) have focused on postmenopausal women and have not come to a clear conclusion. No previous review has summarized the associations between follicle stimulating hormone (FSH), a proxy measure of the menopause transition, and CVD risk. The main purpose of this narrative review is to highlight gaps and limitations in the literature on endogenous estrogen and FSH as related to CVD risk. Future directions are addressed in light of recent findings in the field. When studying the relationship of estrogen to cardiovascular risk, it is critical to separate endogenously produced estrogen from exogenously administered estrogen. Moreover, other reproductive hormones such as FSH should be assessed, since growing evidence suggests a potential contribution of this hormone. Evaluation of estrogen changes over time allows a separation of women based on their hormone trajectories. These individual trajectories correlate with subclinical CVD and thus indicate that it is much more important to observe a woman over time rather than ascribe risk to a single determination at a single time point. As women progress through menopause and the ovary stops producing estradiol, the nature of the relationship between estrogens and subclinical CVD markers also appears to undergo a switch. Studies are needed to examine the midlife course of endogenous estradiol, FSH and CVD risk. These studies should also consider other hormones, including androgens, with an eye towards helping women modify their cardiovascular risk in midlife, when prevention is most likely possible.
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Affiliation(s)
- Samar R El Khoudary
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA, USA.
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Wang H, Li Y, Wang X, Bu J, Yan G, Lou D. Endogenous sex hormone levels and coronary heart disease risk in postmenopausal women: A meta-analysis of prospective studies. Eur J Prev Cardiol 2017; 24:600-611. [PMID: 28326829 DOI: 10.1177/2047487317693133] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Haihui Wang
- Department of Geriatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, China
| | - Yuehua Li
- Department of Geriatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, China
| | - Xinlu Wang
- Department of Geriatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, China
| | - Jianhong Bu
- Department of Geriatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, China
| | - Guoliang Yan
- Department of Geriatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, China
| | - Danfei Lou
- Department of Geriatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, China
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Jaspers L, Kavousi M, Erler NS, Hofman A, Laven JS, Franco OH. Fertile lifespan characteristics and all-cause and cause-specific mortality among postmenopausal women: the Rotterdam Study. Fertil Steril 2017; 107:448-456.e1. [DOI: 10.1016/j.fertnstert.2016.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 11/03/2016] [Accepted: 11/03/2016] [Indexed: 12/17/2022]
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Travison TG, O'Donnell CJ, Bhasin S, Massaro JM, Hoffmann U, Vasan RS, D'Agostino RB, Basaria S. Circulating Sex Steroids and Vascular Calcification in Community-Dwelling Men: The Framingham Heart Study. J Clin Endocrinol Metab 2016; 101:2160-7. [PMID: 26930184 PMCID: PMC4870846 DOI: 10.1210/jc.2015-4299] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The relationship between sex steroids and atherosclerosis is poorly understood. OBJECTIVE To describe the association of serum total T (TT), calculated free T (cFT), estrone (E1), estradiol (E2), and SHBG to vascular calcification in adult men. DESIGN Observational study (Framingham Heart Study). Analyses are cross-sectional. TT, E1, and E2 were measured by liquid chromatography-tandem mass spectrometry, and SHBG by immunofluorometric assay. Estimates of association were obtained by Tobit regression, which acknowledges the influence of floor effects on outcomes. SETTING General community. PARTICIPANTS A total of 1654 community-dwelling men from the Offspring and Third Generation cohorts of the Framingham Heart Study. MAIN OUTCOME MEASURES Coronary artery calcification (CAC), abdominal aortic calcification, and thoracic aortic calcification were measured by computed tomography. RESULTS Mean (standard deviation [SD]) age was 49 (10) years. Mean (SD) TT, cFT, and SHBG were: 616 (224) ng/dL, 111 (45) pg/mL, and 46 (23) nmol/L, respectively. Mean (SD) E2 and E1 were 28 (10) and 39 (14) pg/mL. Vascular calcification at all sites was negatively associated with TT and cFT and positively associated with E2 and E1. A 100-ng/dL between-subjects increase in TT was associated with a mean (95% confidence interval) age-adjusted difference in CAC of -23% (-41%, -4%) (P = .02). After model adjustment for other cardiovascular risk factors, the estimated associations between T and vascular calcification scores were statistically nonsignificant. CONCLUSIONS Decreased circulating T and E2 levels are associated with an age-adjusted increase in CAC, but these associations appear to express relationships either attributable to or mediated by established cardiovascular risk factors.
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Affiliation(s)
- Thomas G Travison
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Christopher J O'Donnell
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Shalender Bhasin
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Joseph M Massaro
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Udo Hoffmann
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Ramachandran S Vasan
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Ralph B D'Agostino
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
| | - Shehzad Basaria
- Hebrew SeniorLife Institute for Aging Research (T.G.T.), Roslindale, Massachusetts 02131; Research Program on Men's Health, Aging and Metabolism (T.G.T., S.Bh., S.Ba.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (T.G.T., C.J.O., S.Bh., U.H., S.Ba.), Boston, Massachusetts 02115; National Heart, Lung and Blood Institute's Framingham Heart Study (C.J.O., J.M.M., R.S.V., R.B.D.), Framingham, Massachusetts 01702; Cardiology Division (C.J.O.), Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114; Department of Biostatistics (J.M.M.), Boston University School of Public Health, Boston, Massachusetts 02118; Department of Radiology (U.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Section of Preventive Medicine and Epidemiology (R.S.V.), Boston University School of Medicine, Boston, Massachusetts 02118; and Department of Mathematics (R.B.D.), Boston University, Boston, Massachusetts 02215
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Qian X, Zhan Q, Lv L, Zhang H, Hong Z, Li Y, Xu H, Chai Y, Zhao L, Zhang G. Steroid hormone profiles plus α-fetoprotein for diagnosing primary liver cancer by liquid chromatography tandem mass spectrometry. Clin Chim Acta 2016; 457:92-8. [PMID: 27060391 DOI: 10.1016/j.cca.2016.03.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 03/28/2016] [Accepted: 03/31/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Primary liver cancer (PLC) is one of the most common malignant tumors world-wide but its pathogenesis is unclear. We suggest that steroid hormones may offer diagnostic information for PLC. METHODS Using liquid chromatography (UPLC) and tandem mass spectrometry (MS/MS), we quantified 7 endogenous steroids in 66 PLC human serum samples, 59 liver cirrhosis (LC) samples, and 65 healthy volunteers (HV). Data were assessed chemometrically and with Mann-Whitney U tests and partial least squares discriminant analysis (PLS-DA). RESULTS For PLC patients, androgens were low and estrogen was high. PLS-DA analysis discriminated between healthy subjects and cancer patients using (estrone+estradiol)/testosterone ratios. Moreover, cirrhosis patients were also distinguished with receiver operating characteristic curves indicating the specificity and sensitivity of our current approach. CONCLUSIONS Steroid hormone profiling by UPLC-MS/MS may be promising for early diagnosis of PLC but investigations with more patients and steroids are required to confirm the utility of these biomarkers for clinical applications.
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Affiliation(s)
- Xian Qian
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Qi Zhan
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Lei Lv
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Hai Zhang
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Zhanying Hong
- Department of Pharmaceutical Analysis, School of Pharmacy, Second Military Medical University, Shanghai 200433, China
| | - Yunqing Li
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Hao Xu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, MI 48109-1065, USA
| | - Yifeng Chai
- Department of Pharmaceutical Analysis, School of Pharmacy, Second Military Medical University, Shanghai 200433, China
| | - Liang Zhao
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China
| | - Guoqing Zhang
- Department of Pharmacy, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
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Vaňková M, Hill M, Velíková M, Včelák J, Vacínová G, Dvořáková K, Lukášová P, Vejražková D, Rusina R, Holmerová I, Jarolímová E, Vaňková H, Kancheva R, Bendlová B, Stárka L. Preliminary evidence of altered steroidogenesis in women with Alzheimer's disease: Have the patients "OLDER" adrenal zona reticularis? J Steroid Biochem Mol Biol 2016; 158:157-177. [PMID: 26704533 DOI: 10.1016/j.jsbmb.2015.12.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 12/07/2015] [Accepted: 12/10/2015] [Indexed: 12/27/2022]
Abstract
Alzheimer's disease (AD) represents more than half of total dementias. Various factors including altered steroid biosynthesis may participate in its pathophysiology. We investigated how the circulating steroids (measured by GC-MS and RIA) may be altered in the presence of AD. Sixteen women with AD and 22 age- and BMI-corresponding controls aged over 65 years were enrolled in the study. The steroid levels (47 steroids and steroid polar conjugates) and their ratios in AD female patients indicated increased CYP11A1 activity, weakened activity of the CYP17A1C17,20 lyase metabolic step and attenuated sulfotransferase SULT2A1 activity at higher activity of the CYP17A1 17-hydroxylase step. The patients showed diminished HSD3B2 activity for C21 steroids, abated conversion of 17-hydroxyprogesterone to cortisol, and significantly elevated cortisol. The women with AD had also attenuated steroid 7α-hydroxylation forming immunoprotective Δ(5)-C19 steroids, attenuated aromatase activity forming estradiol that induces autoimmunity and a shift from the 3β-hydroxy-5α/β-reduced C19 steroids to their neuroinhibitory and antiinflammatory GABAergic 3α-hydroxy- counterparts and showed higher levels of the 3α-hydroxy-5α/β-reduced C21 steroids and pregnenolone sulfate (improves cognitive abilities but may be both protective and excitotoxic). Our preliminary data indicated functioning of alternative "backdoor" pathway in women with AD showing higher levels of both 5α/β-reduced C21 steroids but reduced levels of both 5α/β-reduced C21 steroids, which implied that the alternative "backdoor" pathway might include both 5α- and 5β-reduced steroids. Our study suggested relationships between AD status in women based on the age of subjects and levels of 10 steroids measured by GC-MS.
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Affiliation(s)
- Markéta Vaňková
- Institute of Endocrinology, Národní 8, Prague 116 94, Czech Republic.
| | - Martin Hill
- Institute of Endocrinology, Národní 8, Prague 116 94, Czech Republic.
| | - Marta Velíková
- Institute of Endocrinology, Národní 8, Prague 116 94, Czech Republic.
| | - Josef Včelák
- Institute of Endocrinology, Národní 8, Prague 116 94, Czech Republic.
| | - Gabriela Vacínová
- Institute of Endocrinology, Národní 8, Prague 116 94, Czech Republic.
| | | | - Petra Lukášová
- Institute of Endocrinology, Národní 8, Prague 116 94, Czech Republic.
| | | | - Robert Rusina
- Department of Neurology, Thomayer's Hospital, Vídeňská 800, Prague 140 59, Czech Republic.
| | - Iva Holmerová
- Faculty of Humanities, Charles University in Prague, Ovocný trh 5, Prague 110 00, Czech Republic.
| | - Eva Jarolímová
- Faculty of Humanities, Charles University in Prague, Ovocný trh 5, Prague 110 00, Czech Republic.
| | - Hana Vaňková
- Faculty of Humanities, Charles University in Prague, Ovocný trh 5, Prague 110 00, Czech Republic; Third Faculty of Medicine, Charles University in Prague, Ovocný trh 5, Prague 110 00, Czech Republic.
| | - Radmila Kancheva
- Institute of Endocrinology, Národní 8, Prague 116 94, Czech Republic.
| | - Běla Bendlová
- Institute of Endocrinology, Národní 8, Prague 116 94, Czech Republic.
| | - Luboslav Stárka
- Institute of Endocrinology, Národní 8, Prague 116 94, Czech Republic.
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Davis SR, Wahlin-Jacobsen S. Testosterone in women--the clinical significance. Lancet Diabetes Endocrinol 2015; 3:980-92. [PMID: 26358173 DOI: 10.1016/s2213-8587(15)00284-3] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 07/14/2015] [Accepted: 07/21/2015] [Indexed: 12/21/2022]
Abstract
Testosterone is an essential hormone for women, with physiological actions mediated directly or via aromatisation to oestradiol throughout the body. Despite the crucial role of testosterone and the high circulating concentrations of this hormone relative to oestradiol in women, studies of its action and the effects of testosterone deficiency and replacement in women are scarce. The primary indication for the prescription of testosterone for women is loss of sexual desire, which causes affected women substantial concern. That no formulation has been approved for this purpose has not impeded the widespread use of testosterone by women--either off-label or as compounded therapy. Observational studies indicate that testosterone has favourable cardiovascular effects measured by surrogate outcomes; however, associations between endogenous testosterone and the risk of cardiovascular disease and total mortality, particularly in older women, are yet to be established. Adverse cardiovascular effects have not been seen in studies of transdermal testosterone therapy in women. Clinical trials suggest that exogenous testosterone enhances cognitive performance and improves musculoskeletal health in postmenopausal women. Unmet needs include the availability of approved testosterone formulations for women and studies to elucidate the contribution of testosterone to cardiovascular, cognitive, and musculoskeletal health and the risk of cancer.
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Affiliation(s)
- Susan R Davis
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Sarah Wahlin-Jacobsen
- Department of Sexological Research, Sexological Clinic, Psychiatric Center Copenhagen, Copenhagen, Denmark
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El Khoudary SR, Santoro N, Chen HY, Tepper PG, Brooks MM, Thurston RC, Janssen I, Harlow SD, Barinas-Mitchell E, Selzer F, Derby CA, Jackson EA, McConnell D, Matthews KA. Trajectories of estradiol and follicle-stimulating hormone over the menopause transition and early markers of atherosclerosis after menopause. Eur J Prev Cardiol 2015; 23:694-703. [PMID: 26385249 DOI: 10.1177/2047487315607044] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Indexed: 01/16/2023]
Abstract
AIM The purpose of this study was to assess associations between distinct patterns of circulating estradiol (E2) and follicle-stimulating hormone (FSH) over the menopause transition (MT) and subclinical measures of atherosclerosis after menopause. METHODS AND RESULTS Four temporal patterns of E2 decline (Low: low before and after final menstrual period (FMP); Medium: medium before and high after FMP; High-early decline: high prior to FMP and early decline thereafter; High-late decline: high prior to FMP and late decline thereafter) and three of FSH rise (Low, Medium, High) over 9.6 years across FMP were identified and linked to carotid intima-media-thickness (IMT), adventitial diameter (AD), and presence of carotid plaque (cPlaque) measured after menopause at the 12th annual visit (visit 12). Participants were 856 women (age at visit 12 = 59.5 ± 2.7 years) from the Study of Women's Health Across the Nation (SWAN), who never reported a stroke or a heart attack. In models adjusted for visit 12 or baseline cardiovascular disease (CVD) risk factors, odds of having any cPlaque were ∼43% lower among women with the High-early decline E2 trajectory compared to women with the Low E2 trajectory. In contrast, women with the Medium E2 trajectory had significantly higher IMT than those with the Low E2 trajectory adjusting for visit 12 CVD risk factors. Interestingly, adjusting for baseline CVD risk factors attenuated this association. The Low FSH group had lower IMT than the Medium and High FSH groups (p ≤ 0.05) in all models. CONCLUSION During MT, women are subjected to hormonal alterations that could potentially increase their risk of developing CVD after menopause.
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Affiliation(s)
| | | | - Hsiang-Yu Chen
- Department of Epidemiology, University of Pittsburgh, USA
| | - Ping G Tepper
- Department of Epidemiology, University of Pittsburgh, USA
| | - Maria M Brooks
- Department of Epidemiology, University of Pittsburgh, USA
| | - Rebecca C Thurston
- Department of Epidemiology, University of Pittsburgh, USA Department of Psychiatry, University of Pittsburgh, USA
| | | | | | | | - Faith Selzer
- Department of Epidemiology, University of Pittsburgh, USA
| | - Carol A Derby
- Department of Neurology and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, USA
| | | | | | - Karen A Matthews
- Department of Epidemiology, University of Pittsburgh, USA Department of Psychiatry, University of Pittsburgh, USA
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Abstract
OBJECTIVE Menopause is defined as the permanent cessation of menses. Although previous studies demonstrated a slight production of androgens and estrogens by postmenopausal ovaries, the impact of hormone production on lipid metabolism is still uncertain. The aim of this study was to evaluate whether the postmenopausal ovary is hormonally active and whether hormone status contributes to lipid metabolism. METHODS This was a prospective study of 87 women who were treated for gynecological diseases (29% had cervical cancer, 49% had endometrial cancer, 7% had fibroid tumors, and 15% had cervical intraepithelial neoplasia). They were categorized as early postmenopausal (n = 40; mean [SD], 56.8 [3.8] y) or late postmenopausal (n = 47; mean [SD], 66.6 [5.7] y) women. Serum specimens were collected from the peripheral and ovarian veins of participants undergoing bilateral oophorectomy. Sex steroid hormone levels and lipid profiles were determined. RESULTS Statistically significant differences in estradiol (E2) and testosterone were seen between the ovarian samples and the peripheral samples in all groups. E2 and estrone obtained from ovarian venous samples gradually decreased with age in postmenopausal women. There was a significant correlation between ovarian E2 and high-density lipoprotein cholesterol levels and the low-density lipoprotein-to-high-density lipoprotein ratio. However, there was no correlation between peripheral E2 levels and any of the lipid parameters examined. CONCLUSIONS Although this study investigates women with gynecological diseases, the postmenopausal ovary is hormonally active, and the E2 produced by postmenopausal ovaries may therefore contribute to the maintenance of lipid metabolism.
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Relationship between CYP17A1 genetic polymorphism and coronary artery disease in a Chinese Han population. Lipids Health Dis 2015; 14:16. [PMID: 25889125 PMCID: PMC4359393 DOI: 10.1186/s12944-015-0007-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 01/29/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND CYP17A1 gene encodes P450c17 proteins, which is a key enzyme that catalyzes the formation of sex hormones. Many clinical studies showed that sex hormones levels play an important role in the pathogenesis of coronary artery disease (CAD). However, the relationship between CYP17A1 genetic polymorphisms and CAD remains unclear. The aim of this study was to investigate the association of CYP17A1 genetic polymorphisms with CAD in a Han population of China. METHODS A total of 997 people include 490 patients and 507 controls were selected for the present study. Five single-nucleotide polymorphisms (SNPs) (rs4919686, rs1004467, rs4919687, rs10786712, and rs2486758) were genotyped by using the real-time PCR (TaqMan) method. RESULTS For men, the rs10786712 was found to be associated with CAD in a recessive model (P=0.016), after adjustment of the major confounding factors, the significant difference was retained (OR=1.644, 95% confidence interval [CI]: 1.087-2.488, P=0.019). For women, the rs1004467 was also found to be associated with CAD in a dominant model (P=0.038), the difference remained statistically significant after multivariate adjustment (OR=1.623, 95% CI: 1.023-2.576, P=0.040). The distribution of rs4919687 genotypes showed a significant difference between CAD and control participants in a recessive model (P=0.019), the significant difference was retained after adjustment for covariates (OR=0.417, 95% CI: 0.188-0.926, P=0.032). CONCLUSION Rs1004467, rs4919687, rs10786712 of CYP17A1 gene are associated with CAD in Han population of China. The TT genotype of rs10786712 could be a protective genetic marker of CAD in men. The CC genotype of rs1004467 and the AA genotype of rs4919687 could be risk genetic markers of CAD in women. However, large sample size study including other SNPs of CYP17A1 should be performed in future studies.
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Dai CF, Xie X, Ma YT, Yang YN, Li XM, Fu ZY, Liu F, Chen BD, Gai MT. Haplotype analyses of CYP17A1 genetic polymorphisms and coronary artery disease in a Uygur population. J Renin Angiotensin Aldosterone Syst 2015; 16:389-98. [PMID: 25592814 DOI: 10.1177/1470320314565840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The relationship between CYP17A1 genetic polymorphisms and coronary artery disease (CAD) remains unclear. The aim of the present study was to assess the association between CYP17A1 gene polymorphism and CAD in a Chinese Uygur population. METHODS A total of 493 people including 266 patients and 227 controls were selected for the present study. All CAD patients and controls were genotyped for the same five single nucleotide polymorphisms (SNPs) (rs4919686, rs1004467, rs4919687, rs10786712, and rs2486758) by a real-time PCR method. RESULTS The rs4919686, rs1004467, and rs4919687 polymorphisms were found to be associated with CAD in genotypes, dominant model, recessive model, and allele frequency (rs4919686: all p<0.05, rs1004467: all p ≤ 0.001, rs4919687: all p<0.001); the significant difference was retained (all p<0.05) after adjustment for the major confounding factors. The overall distribution of haplotypes established by SNP1-SNP4 (in total subjects and men) and SNP1-SNP4-SNP5 (in total subjects) were significantly different between the CAD patients and the control subjects (p=0.006, men: p=0.026, and p=0.030, respectively). CONCLUSION Polymorphisms rs4919686, rs4919687 and rs1004467 were found to be associated with CAD in this Uygur population.
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Affiliation(s)
- Chuan-Fang Dai
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 P.R., China
| | - Xiang Xie
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 P.R., China
| | - Yi-Tong Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 P.R., China
| | - Yi-Ning Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 P.R., China
| | - Xiao-Mei Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 P.R., China
| | - Zhen-Yan Fu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 P.R., China
| | - Fen Liu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 P.R., China
| | - Bang-Dang Chen
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 P.R., China
| | - Min-Tao Gai
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054 P.R., China
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Vanderschueren D, Laurent MR, Claessens F, Gielen E, Lagerquist MK, Vandenput L, Börjesson AE, Ohlsson C. Sex steroid actions in male bone. Endocr Rev 2014; 35:906-60. [PMID: 25202834 PMCID: PMC4234776 DOI: 10.1210/er.2014-1024] [Citation(s) in RCA: 185] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Sex steroids are chief regulators of gender differences in the skeleton, and male gender is one of the strongest protective factors against osteoporotic fractures. This advantage in bone strength relies mainly on greater cortical bone expansion during pubertal peak bone mass acquisition and superior skeletal maintenance during aging. During both these phases, estrogens acting via estrogen receptor-α in osteoblast lineage cells are crucial for male cortical and trabecular bone, as evident from conditional genetic mouse models, epidemiological studies, rare genetic conditions, genome-wide meta-analyses, and recent interventional trials. Genetic mouse models have also demonstrated a direct role for androgens independent of aromatization on trabecular bone via the androgen receptor in osteoblasts and osteocytes, although the target cell for their key effects on periosteal bone formation remains elusive. Low serum estradiol predicts incident fractures, but the highest risk occurs in men with additionally low T and high SHBG. Still, the possible clinical utility of serum sex steroids for fracture prediction is unknown. It is likely that sex steroid actions on male bone metabolism rely also on extraskeletal mechanisms and cross talk with other signaling pathways. We propose that estrogens influence fracture risk in aging men via direct effects on bone, whereas androgens exert an additional antifracture effect mainly via extraskeletal parameters such as muscle mass and propensity to fall. Given the demographic trends of increased longevity and consequent rise of osteoporosis, an increased understanding of how sex steroids influence male bone health remains a high research priority.
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Affiliation(s)
- Dirk Vanderschueren
- Clinical and Experimental Endocrinology (D.V.) and Gerontology and Geriatrics (M.R.L., E.G.), Department of Clinical and Experimental Medicine; Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine (M.R.L., F.C.); and Centre for Metabolic Bone Diseases (D.V., M.R.L., E.G.), KU Leuven, B-3000 Leuven, Belgium; and Center for Bone and Arthritis Research (M.K.L., L.V., A.E.B., C.O.), Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden
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Kyvernitakis I, Albert US, Kalder M, Winarno AS, Hars O, Hadji P. Effect of anastrozole on hormone levels in postmenopausal women with early breast cancer. Climacteric 2014; 18:63-8. [PMID: 24884402 DOI: 10.3109/13697137.2014.929105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the influence of anastrozole on serum hormone levels in postmenopausal women with hormone receptor-positive breast cancer. METHODS We prospectively determined serum levels of estradiol, testosterone, dehydroepiandrosterone sulfate (DHEAS), sex hormone binding globulin (SHBG), follicle stimulating hormone (FSH) and luteinizing hormone (LH) at screening, as well as after 12 and 24 months of treatment and studied the associations with markers of bone turnover and bone mineral density (BMD). RESULTS Altogether, a full set of hormone levels was available for 70 patients. Anastrozole treatment led to decreases of 92.1% for estradiol and 11.1% for LH over the observation period (p < 0.001). Conversely, FSH, DHEAS and testosterone concentrations increased by 5.9%, 33.3% and 50%, respectively (p < 0.001). SHBG levels remained stable during the 24 months of treatment (p = 0.355). There were modest associations between FSH, SHBG, CrossLaps and N-terminal propeptide of human procollagen type I (p < 0.05). Moreover, SHBG correlated positively with the BMD of femoral neck, total hip, total hip T-score, lumbar spine and the lumbar spine T-score, whereas FSH and estradiol correlated with the lumbar spine T-score (p < 0.05). CONCLUSIONS During the 24 months of follow-up, treatment with anastrozole decreased the serum levels of estradiol and LH. Furthermore, we found notable increases of serum levels of FSH, DHEAS and testosterone in the first 12 months of treatment, stabilizing thereafter. Additionally, we were able to correlate hormone levels with markers of bone turnover and BMD for the first time in this regard.
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Affiliation(s)
- I Kyvernitakis
- Department of Gynecology and Obstetrics, Reproductive Medicine and Osteoporosis, Philipps-University of Marburg , Germany
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Veldhuis JD, Bondar OP, Dyer RB, Trushin SA, Klee EW, Singh RJ, Klee GG. Immunological and mass spectrometric assays of SHBG: consistent and inconsistent metabolic associations in healthy men. J Clin Endocrinol Metab 2014; 99:184-93. [PMID: 24203061 PMCID: PMC3879680 DOI: 10.1210/jc.2013-2642] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT SHBG concentrations correlate inconsistently with metabolic parameters. HYPOTHESIS SHBG assay platforms contribute to nonuniformities according to the literature. DESIGN The design of the study was a noninterventional quantification of SHBG by two immuno- and two mass spectrometric assays and abdominal visceral fat by computed tomography scan. SETTING The study was conducted at the Center for Translational Science Activities. PARTICIPANTS Healthy men (n=120) aged 18-80 years with a body mass index of 20-43 kg/m2 participated I the study. OUTCOMES Outcomes of the study included a correlation of log SHBG with age, metabolic surrogates [body mass index, albumin, glucose, insulin, abdominal (total and visceral) fat, homeostasis model assessment insulin resistance index], sex steroids (estrone, 17β-estradiol, T, and dihydrotestosterone by mass spectrometry), and adipocytokines (IL-1β, IL-6, IL-8, IL-10 and IL-12, TNF-α, and adiponectin). RESULTS By univariate regression, age (P<10(-4)), dihydrotestosterone (P<10(-4)), T (P≤.00022), and adiponectin (P≤.0084) were positive correlates, and insulin and homeostasis model assessment insulin resistance index were negative correlates (P≤.0060) of SHBG in all four assays. Stepwise multivariate analysis unveiled that age and T together could explain 38.1%-52.5% of the statistical variance in SHBG in all assays (P<10(-11)). Multivariate regression without sex steroids unveiled that age (P<10(-5)) and insulin (P<10(-3)) are jointly associated with SHBG levels in the four assays with overall R2=0.215-0.293 and P<10(-6). In one immunological SHBG assay each, abdominal visceral fat and adiponectin were weak multivariates also. CONCLUSION Immunological and mass spectrometric SHBG assays yield both consistent and inconsistent correlations with key metabolic variables in healthy men, thereby potentially explaining earlier inconsistencies in the literature.
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Affiliation(s)
- Johannes D Veldhuis
- Endocrine Research Unit (J.D.V.), Mayo School of Graduate Medical Education Center for Translational Science Activities, Immunochemical Laboratory (R.B.D.), and Departments of Neurology (S.A.T.) and Laboratory Medicine and Pathology (J.D.V., O.P.B., E.W.K., R.J.S., G.G.K.), Mayo Clinic, Rochester, Minnesota 55905
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Durdiaková J, Fábryová H, Koborová I, Ostatníková D, Celec P. The effects of saliva collection, handling and storage on salivary testosterone measurement. Steroids 2013; 78:1325-31. [PMID: 24051109 DOI: 10.1016/j.steroids.2013.09.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 08/28/2013] [Accepted: 09/03/2013] [Indexed: 10/26/2022]
Abstract
Several endocrine parameters commonly measured in plasma, such as steroid hormones, can be measured in the oral fluid. However, there are several technical aspects of saliva sampling and processing that can potentially bias the validity of salivary testosterone measurement. The aim of this study was to evaluate the effects caused by repeated sampling; 5 min centrifugation (at 2000, 6000 or 10,000g); the stimulation of saliva flow by a cotton swab soaked in 2% citric acid touching the tongue; different storage times and conditions as well as the impact of blood contamination on salivary testosterone concentration measured using a commercially available ELISA kit. Fresh, unprocessed, unstimulated saliva samples served as a control. Salivary testosterone concentrations were influenced neither by repeated sampling nor by stimulation of salivary flow. Testosterone levels determined in samples stored in various laboratory conditions for time periods up to 1 month did not differ in comparison with controls. For both genders, salivary testosterone levels were substantially reduced after centrifugation (men F=29.1; women F=56.17, p<0.0001). Blood contamination decreased salivary testosterone levels in a dose-dependent manner (men F=6.54, p<0.01, F=5.01, p<0.05). Salivary testosterone can be considered A robust and stable marker. However, saliva processing and blood leakage can introduce bias into measurements of salivary testosterone using ELISA. Our observations should be considered in studies focusing on salivary testosterone.
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Affiliation(s)
- Jaroslava Durdiaková
- Institute of Physiology, Comenius University, Bratislava, Slovakia; Institute of Molecular Biomedicine, Comenius University, Bratislava, Slovakia.
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Abstract
OBJECTIVE Women with breast cancer who are treated with aromatase inhibitors often experience vaginal atrophy symptoms and sexual dysfunction. This work aims to study proliferation and the presence and distribution of steroid hormone receptors in vaginal biopsies in relation to vaginal atrophy and vaginal pH in women with breast cancer who are on adjuvant endocrine treatment and in healthy postmenopausal women. METHODS This is a cross-sectional study that compares postmenopausal aromatase inhibitor-treated women with breast cancer (n = 15) with tamoxifen-treated women with breast cancer (n = 16) and age-matched postmenopausal women without treatment (n = 19) or with vaginal estrogen therapy (n = 16). Immunohistochemistry was used to study proliferation and steroid hormone receptor staining intensity. Data was correlated with estrogen and androgen levels, vaginal atrophy scores, and vaginal pH. RESULTS Aromatase inhibitor-treated women had a lower grade of proliferation, weaker progesterone receptor staining, and stronger androgen receptor staining, which correlated with plasma estrone levels, vaginal atrophy scores, and vaginal pH. CONCLUSIONS Women with aromatase inhibitor-treated breast cancer exhibit reduced proliferation and altered steroid hormone receptor staining intensity in the vagina, which are related to clinical signs of vaginal atrophy. Although these effects are most probably attributable to estrogen suppression, a possible local inhibition of aromatase cannot be ruled out.
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Baumgart J, Nilsson K, Stavreus Evers A, Kunovac Kallak T, Kushnir MM, Bergquist J, Sundström Poromaa I. Androgen levels during adjuvant endocrine therapy in postmenopausal breast cancer patients. Climacteric 2013; 17:48-54. [DOI: 10.3109/13697137.2013.800039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Crandall CJ, Barrett-Connor E. Endogenous sex steroid levels and cardiovascular disease in relation to the menopause: a systematic review. Endocrinol Metab Clin North Am 2013; 42:227-53. [PMID: 23702399 DOI: 10.1016/j.ecl.2013.02.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Heart disease remains a major cause of death among women in the United States. This article focuses on physiologic endogenous estrogen levels with a systematic review of literature related to endogenous sex steroid levels and coronary artery disease (CAD) among postmenopausal women with natural or surgical menopause. There is adequate reason to seek evidence for associations of circulating estrogen levels and CAD. In the future, even if ovarian senescence-associated hormonal changes are confirmed to be associated with CAD in cohort studies of postmenopausal women, there may be other components explaining the gender differences in CAD patterns.
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Affiliation(s)
- Carolyn J Crandall
- Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA 90024, USA.
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42
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Endogenous estrogen and androgen levels are not independent predictors of lipid levels in postmenopausal women. Menopause 2013; 20:640-5. [DOI: 10.1097/gme.0b013e318279bd4a] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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44
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Haring R, Teng Z, Xanthakis V, Coviello A, Sullivan L, Bhasin S, Murabito JM, Wallaschofski H, Vasan RS. Association of sex steroids, gonadotrophins, and their trajectories with clinical cardiovascular disease and all-cause mortality in elderly men from the Framingham Heart Study. Clin Endocrinol (Oxf) 2013; 78:629-34. [PMID: 22901104 PMCID: PMC4161203 DOI: 10.1111/cen.12013] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 04/25/2012] [Accepted: 08/09/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Emerging data from longitudinal studies suggest that low sex steroid concentrations in men are associated with increased cardiovascular risk and mortality. The impact of longitudinal trajectory patterns from serial sex steroid and gonadotrophin measurements on the observed associations is unknown to date. METHODS We prospectively evaluated 254 elderly men (mean age, 75·5 years) of the Framingham Heart Study with up to four serial measurements of serum total testosterone (TT), dehydroepiandrosterone sulphate (DHEAS), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and total estradiol (EST); and constructed age- and multivariable-adjusted Cox proportional hazard regression models relating baseline hormone concentrations and their mean, slope and variation over time (modelled as continuous and categorized into quartiles) to the incidence of clinical cardiovascular disease (CVD) and all-cause mortality at 5- and 10-year follow-up. RESULTS We observed no association between baseline concentrations of sex steroids, gonadotrophins and their trajectories with incident clinical CVD over 5- and 10-year follow-up. Although higher baseline TT concentrations were associated with lower mortality risk at 5 years (hazard ratio per quartile increment, 0·74; 95% confidence interval, 0·56-0·98), correction for multiple statistical testing (P < 0·005) rendered this association statistically nonsignificant. Repeat analyses at the 10-year follow-up time point also demonstrated no significant association between sex steroids, gonadotrophins or their trajectories and mortality. CONCLUSION Investigating longitudinal trajectory patterns of serial sex steroid and gonadotrophin measurements, the present study found no consistent associations with incident clinical CVD and all-cause mortality risk in elderly men from the community.
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Affiliation(s)
- Robin Haring
- Preventive Medicine & Epidemiology Section, School of Medicine, Boston University, Boston, MA, USA.
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45
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Abdel-Khalik J, Björklund E, Hansen M. Simultaneous determination of endogenous steroid hormones in human and animal plasma and serum by liquid or gas chromatography coupled to tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 2013; 928:58-77. [PMID: 23598050 DOI: 10.1016/j.jchromb.2013.03.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Revised: 03/05/2013] [Accepted: 03/13/2013] [Indexed: 01/20/2023]
Abstract
Analytical methodologies based on liquid or gas chromatography coupled to tandem mass spectrometry for the simultaneous determination of two or more endogenous steroid hormones in human and animal plasma and serum has received increased attention the last few years. Especially in the clinical setting steroid profiling is of major importance in disease diagnostics. This paper discusses recent findings in such multi-steroid hormone procedures published from 2001 to 2012. The aim was to elucidate possible relationships between chosen analytical technique and the obtained analyte sensitivity for endogenous steroid hormones. By evaluating the success, at which the currently applied techniques have been utilized, more general knowledge on the field is provided. Furthermore the evaluation provides directions in which future studies may be interesting to conduct.
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Affiliation(s)
- Jonas Abdel-Khalik
- Toxicology Laboratory, Analytical Biosciences, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark.
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Association of stromal-derived factor-1 alpha and endogenous sex hormones in men aged over 50 years with stable coronary artery disease. Adv Med Sci 2012. [PMID: 23192056 DOI: 10.2478/v10039-012-0051-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE Many studies indicate an inverse relationship between stromal-derived factor-1 alpha (SDF-1 alpha), a chemokine, and coronary risk factors. Moreover, SDF-1 alpha is crucial in neoangiogenesis and in the mobilization and homing of endothelial progenitor cells to the ischemic coronary vessels. Numerous studies indicate that circulating sex hormones are associated with atherogenesis during male aging. The aim of this study was therefore to determine whether there exists a relationship between SDF-1 alpha and endogenous sex hormones in aging men with stable coronary artery disease (CAD). MATERIAL AND METHODS Plasma concentrations of SDF-1 alpha, testosterone (T), estradiol (E2), and sex hormone binding globulin (SHBG) were measured and the E2/T ratio was calculated in a cross-sectional study of 82 men over 50 years of age with stable CAD. RESULTS SDF-1 alpha was positively and significantly correlated with T (r = 0.233; p = 0.036) and with SHBG (r = 0.312; p = 0.004). There was a significant inverse correlation between SDF-1 alpha and the E2/T ratio (r = -0.463; p < 0.001). After adjustment for age, body mass index and smoking status, SHBG and E2/T ratio were the only factors associated with SDF-1 alpha. CONCLUSIONS T and SHBG (directly) and the E2/T ratio (inversely) may be involved in the etiopathogenesis of CAD through their relationships to SDF-1 alpha.
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Zheng H, Li Y, Dai W, Wei C, Sun K, Tong Y. Role of Endogenous Estrogen on the Incidence of Coronary Heart Disease in Men. Angiology 2012; 63:591-6. [PMID: 22241543 DOI: 10.1177/0003319711432626] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Estrogens protect the vascular system in women, but its effect in men is unclear. We evaluated the impact of estrogen on the male cardiovascular system. Of 140 Chinese males, 55 (aged 61.2 ± 3.5) were cases and 60 (aged 59.5 ± 4.6) were controls. Compared with the control group, only serum estradiol ([E2]; P < .01) levels but not testosterone ([T]; P = .21) were significantly lower in the cases. Linear and multiple regression analysis showed that serum T was positively associated with triglycerides ([TG]; r = .439, P < .01) and d-dimer ( r = .258, P < .05) but negatively associated with high-density lipoprotein cholesterol (HDL-C) levels ( r = −.267, P < .05) and C-reactive protein (CRP; r = −.214, P < .05). Estradiol was highly associated with TG ( r = .783, P < .01) and HDL-C ( r = .515, P < .01) but was negatively related with low-density lipoprotein cholesterol (LDL-C; P < .05), total cholesterol/HDL-C ( P < .05), CRP ( P < .01), and d-dimer ( P < .01). In conclusion, serum E2 and T levels affect coronary heart disease risk factors in males.
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Affiliation(s)
- Hongyun Zheng
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yan Li
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wen Dai
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Chuandong Wei
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Kaisheng Sun
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yongqing Tong
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
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Pappa T, Vemmos K, Saltiki K, Mantzou E, Stamatelopoulos K, Alevizaki M. Severity and outcome of acute stroke in women: relation to adrenal sex steroid levels. Metabolism 2012; 61:84-91. [PMID: 21820139 DOI: 10.1016/j.metabol.2011.06.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2011] [Revised: 06/03/2011] [Accepted: 06/05/2011] [Indexed: 11/18/2022]
Abstract
Adrenal sex steroids exert diverse metabolic and neurobiological actions. Their levels have been associated with cardiovascular disease, but data concerning cerebrovascular disease are lacking. The objective of our study was to investigate the role of adrenal sex steroids in a female population suffering an acute stroke. We addressed the question of whether their levels are associated with disease severity and prognosis. A 2-year cohort study was performed in 2 tertiary hospitals, where we prospectively studied 302 consecutive postmenopausal female patients hospitalized for an acute stroke. Neurological severity on admission was assessed by the National Institutes of Health Stroke Scale; and handicap 1 month after stroke, with the modified Rankin Scale. Δ4-androstenedione levels were positively and dehydroepiandrosterone sulfate was inversely associated with stroke severity (r = 0.142, P = .014 and r = -0.153, P = .008, respectively), and both parameters remained as significant determinants even after entering other confounders in the multivariate model (r = 0.118, P = .039 and r = -0.150, P = .011, respectively). Levels of Δ4-androstenedione were significantly associated with 1-month mortality in the multivariate analysis (odds ratio with 95% confidence intervals: 1.540 [1.107-2.138)], P = .010). Δ4-androstenedione and dehydroepiandrosterone sulfate levels were associated with poor outcome in the univariate analysis, that is, combined severe handicap (modified Rankin Scale ≥4) and death, 1 month poststroke, although this was not significant in the multivariate analysis. Adrenal sex steroids, and especially Δ4-androstenedione, are significantly associated with stroke severity on admission and short-term prognosis among female stroke subjects. Well-designed prospective studies will further clarify their role in cerebrovascular disease.
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Affiliation(s)
- Theodora Pappa
- Endocrine Unit, Department of Clinical Therapeutics, Alexandra Hospital, Athens University School of Medicine, Greece.
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Callou de Sá EQ, Feijó de Sá FC, e Silva RDS, de Oliveira KC, Guedes AD, Feres F, Verreschi ITDN. Endogenous oestradiol but not testosterone is related to coronary artery disease in men. Clin Endocrinol (Oxf) 2011; 75:177-83. [PMID: 21521286 DOI: 10.1111/j.1365-2265.2011.04017.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Men die of coronary artery disease (CAD) more often than women. There is evidence that testosterone either is neutral or has a beneficial effect on male cardiovascular disease. The role of oestrogens in male CAD has been less studied. This study was carried out with the purpose of evaluating the relationship between sex hormone levels and CAD. DESIGN Case-control study. PARTICIPANTS Men (aged 40-70) submitted to coronary angiography. A 70% occlusion of at least one major coronary artery defined the cases; subjects with ≤ 50% occlusion constituted the control group. MEASUREMENTS Blood samples were collected for total testosterone (TT), oestradiol, luteinizing hormone, follicle-stimulating hormone, sex hormone-binding globulin, lipid profile and albumin measurements. Bioavailable and free testosterone, free androgen index (FAI) and free oestrogen index (FEI) were calculated. Oestradiol and TT levels were examined as terciles, based on the whole study population. RESULTS Of the 140 patients included, 72 were cases and 68 were controls. The baseline characteristics of the two groups were similar, except for the older age and lower LDL-C in the cases. Oestradiol and FEI but not total, bioavailable and free testosterone and FAI correlated positively with CAD. After adjustments for potential confounders, oestradiol remained statistically significant. The prevalence of CAD was significantly higher in the 3rd than in the 1st tercile of oestradiol. CONCLUSION In this study, men with CAD had higher oestradiol and FEI levels. Additional studies are needed to clarify the direction of causality and possible underlying mechanisms.
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