CONTEXT:Estrogen treatment of men with prostate cancer is associated with increased cardiovascular morbidity and mortality; however, the role of endogenous estrogen levels for atherosclerotic disease in men is unknown. OBJECTIVE:The objective of the study was to determine whether endogenous serum estradiol (E2) levels predict the progression of carotid artery intima-media thickness in men. DESIGN, SETTING AND PARTICIPANTS:This was a population-based, prospective cohort study (the Atherosclerosis and Insulin Resistance study) conducted in Göteborg, Sweden, among 313 Caucasian men without cardiovascular or other clinically overt diseases. Carotid artery intima-media thickness, an index of preclinical atherosclerosis, was measured by ultrasound at baseline (58 yr of age) and after 3 yr of follow-up. Serum sex hormone levels and cardiovascular risk factors (body mass index, waist to hip ratio, systolic blood pressure, serum triglycerides, plasma c-peptide, and smoking status) were assessed at study entry. INTERVENTION:There was no intervention. MAIN OUTCOME MEASURES:Association between baseline total and free E2 levels and progression of carotid intima-media thickness over 3 yr with adjustments for cardiovascular risk factors was measured. RESULTS:In univariate analyses, both total and free E2 levels at baseline were positively associated with the annual change in intima-media thickness. In linear regression models including E2 and cardiovascular risk factors, low-density lipoprotein and high-density lipoprotein cholesterol and E2 were identified as independent predictors of progression of carotid artery intima-media thickness (total E2 beta = 0.187, P = 0.001; and free E2 beta = 0.183, P = 0.003). CONCLUSIONS:Circulating E2 is a predictor of progression of carotid artery intima-media thickness in middle-aged men. Further studies are needed to investigate the role of endogenous E2 for incident cardiovascular disease events.

译文

背景:雌激素治疗前列腺癌的男性会增加心血管疾病的发病率和死亡率。然而,内源性雌激素水平在男性动脉粥样硬化疾病中的作用尚不清楚。
目的:研究的目的是确定内源性血清雌二醇(E2)水平是否可预测男性颈动脉内膜中层厚度的发展。
设计,地点和参与者:这是一项在瑞典哥德堡进行的基于人群的前瞻性队列研究(动脉粥样硬化和胰岛素抵抗研究),研究对象是313名无心血管疾病或其他临床明显疾病的白人。在基线(58岁)和随访3年后,通过超声测量颈动脉内膜中层厚度(临床前动脉粥样硬化的指标)。在研究开始时评估了血清性激素水平和心血管危险因素(体重指数,腰围与臀部的比率,收缩压,血清甘油三酸酯,血浆c肽和吸烟状况)。
干预:没有干预。
主要观察指标:测量基线总E2水平和游离E2水平与3年以上颈动脉内膜中膜厚度进展的相关性,并调整心血管危险因素。
结果:在单变量分析中,基线时的总E2水平和游离E2水平均与内膜中膜厚度的年度变化呈正相关。在包括E2和心血管危险因素的线性回归模型中,低密度脂蛋白和高密度脂蛋白胆固醇和E2被确定为颈动脉内膜-中膜厚度进展的独立预测因子(总E2 beta = 0.187,P = 0.001;免费) E2 beta = 0.183,P = 0.003)。
结论:循环E2是中年男性颈动脉内膜中层厚度发展的预测指标。需要进一步的研究来研究内源性E2在心血管事件中的作用。

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