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Low serum testosterone and high serum estradiol associate with lower extremity peripheral arterial disease in elderly men - The MrOS study in Sweden

Tivesten, Asa; Mellstroem, Dan; Jutberger, Hans; Fagerberg, Bjbrn; Lernfelt, Bodil; Orwoll, Eric; Karlsson, Magnus LU ; Ljunggren, Osten and Ohlsson, Claes (2007) In Journal of the American College of Cardiology 50(11). p.1070-1076
Abstract
Objectives This study sought to determine whether serum levels of testosterone and estradiol associate with lower extremity peripheral arterial disease (PAD) in a large population-based cohort of elderly men. Background Few studies have explored the relationship between serum sex steroids and lower extremity PAD in men. Methods The Swedish arm of the MrOS (Osteoporotic Fractures in Men) study (n = 3,014; average age 75.4 years) assessed ankle-brachial index (ABI) and defined lower extremity PAD as ABI < 0.90. Radioimmunoassay measured serum levels of total testosterone, estradiol, and sex hormone-binding globulin, and we calculated free testosterone and free estradiol levels from the mass action equations. Results A linear regression... (More)
Objectives This study sought to determine whether serum levels of testosterone and estradiol associate with lower extremity peripheral arterial disease (PAD) in a large population-based cohort of elderly men. Background Few studies have explored the relationship between serum sex steroids and lower extremity PAD in men. Methods The Swedish arm of the MrOS (Osteoporotic Fractures in Men) study (n = 3,014; average age 75.4 years) assessed ankle-brachial index (ABI) and defined lower extremity PAD as ABI < 0.90. Radioimmunoassay measured serum levels of total testosterone, estradiol, and sex hormone-binding globulin, and we calculated free testosterone and free estradiol levels from the mass action equations. Results A linear regression model including age, current smoking, previous smoking, diabetes, hypertension, body mass index, free testosterone, and free estradiol showed that free testosterone independently and positively associates with ABI (p < 0.001), whereas free estradiol independently and negatively associates with ABI (p < 0.001). Logistic regression analyses showed that free testosterone in the lowest quartile (vs. quartiles 2 to 4; odds ratio [OR] 1.65, 95% confidence interval [Cl] 1.22 to 2.23, p = 0.001) and free estradiol in the highest quartile (vs. quartiles 1 to 3; OR 1.45, 95% Cl 1.09 to 1.94, p = 0.012) independently associate with lower extremity PAD. Conclusions This cross-sectional study shows for the first time that low serum testosterone and high serum estradiol levels associate with lower extremity PAD in elderly men. Future prospective and interventional studies are needed to establish possible causal relationships between sex steroids and the development of lower extremity PAD in men. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of the American College of Cardiology
volume
50
issue
11
pages
1070 - 1076
publisher
Elsevier USA
external identifiers
  • wos:000249348100010
  • scopus:34548417939
ISSN
0735-1097
DOI
10.1016/j.jacc.2007.04.088
language
English
LU publication?
yes
id
a909801d-65d8-406b-85f7-89b7b35027f6 (old id 657123)
date added to LUP
2007-12-19 16:26:54
date last changed
2017-06-25 03:42:35
@article{a909801d-65d8-406b-85f7-89b7b35027f6,
  abstract     = {Objectives This study sought to determine whether serum levels of testosterone and estradiol associate with lower extremity peripheral arterial disease (PAD) in a large population-based cohort of elderly men. Background Few studies have explored the relationship between serum sex steroids and lower extremity PAD in men. Methods The Swedish arm of the MrOS (Osteoporotic Fractures in Men) study (n = 3,014; average age 75.4 years) assessed ankle-brachial index (ABI) and defined lower extremity PAD as ABI &lt; 0.90. Radioimmunoassay measured serum levels of total testosterone, estradiol, and sex hormone-binding globulin, and we calculated free testosterone and free estradiol levels from the mass action equations. Results A linear regression model including age, current smoking, previous smoking, diabetes, hypertension, body mass index, free testosterone, and free estradiol showed that free testosterone independently and positively associates with ABI (p &lt; 0.001), whereas free estradiol independently and negatively associates with ABI (p &lt; 0.001). Logistic regression analyses showed that free testosterone in the lowest quartile (vs. quartiles 2 to 4; odds ratio [OR] 1.65, 95% confidence interval [Cl] 1.22 to 2.23, p = 0.001) and free estradiol in the highest quartile (vs. quartiles 1 to 3; OR 1.45, 95% Cl 1.09 to 1.94, p = 0.012) independently associate with lower extremity PAD. Conclusions This cross-sectional study shows for the first time that low serum testosterone and high serum estradiol levels associate with lower extremity PAD in elderly men. Future prospective and interventional studies are needed to establish possible causal relationships between sex steroids and the development of lower extremity PAD in men.},
  author       = {Tivesten, Asa and Mellstroem, Dan and Jutberger, Hans and Fagerberg, Bjbrn and Lernfelt, Bodil and Orwoll, Eric and Karlsson, Magnus and Ljunggren, Osten and Ohlsson, Claes},
  issn         = {0735-1097},
  language     = {eng},
  number       = {11},
  pages        = {1070--1076},
  publisher    = {Elsevier USA},
  series       = {Journal of the American College of Cardiology},
  title        = {Low serum testosterone and high serum estradiol associate with lower extremity peripheral arterial disease in elderly men - The MrOS study in Sweden},
  url          = {http://dx.doi.org/10.1016/j.jacc.2007.04.088},
  volume       = {50},
  year         = {2007},
}