Endogenous Estradiol and Testosterone may Predispose toward Atherogenic Lipid Profile, but Higher Blood Level of Testosterone is Associated with Lower Number of Stenoses in the Coronary Arteries of Men with Coronary Disease

OBJECTIVES: To assess the correlations between blood levels of sex steroid hormones and blood lipid profile or the degree of coronary artery stenosis in men with coronary artery disease (CAD). METHODS: 111 men with stable CAD, aged 36-73 yrs, unselected for the coexisting clinical coronary risk factors were prospectively studied. Degree of coronary stenosis was assessed angiographically using different indices. Total cholesterol (T-Ch), high density lipoproteins cholesterol (HDL-Ch), low density lipoproteins cholesterol (LDL-Ch), triglicerydes (TG), testosterone, estradiol, dehydroepiandrosterone sulfate (DHEA-S), and sex hormone binding globulin (SHBG) were measured in the blood. Free testosterone index (FTI) was calculated. RESULTS: A positive, significant correlations were found between blood concentrations of estradiol and T-Ch (r=0.29, p<0.01) or LDL-Ch (r=0.34, p<0.005) as well as between FTI and blood LDL-Ch (r=0.23, p<0.05). Blood level of estradiol negatively correlated with HDL-Ch/T-Ch ratio (r=-0.21, p<0.05). While blood levels of T-Ch correlated positively with 3 out of 5 applied here indices of coronary stenosis, blood LDL-Ch with two of them. In turn, blood level of testosterone negatively correlated with one index of coronary stenosis (r=-0.26, p<0.05). CONCLUSION: In men with CAD, plasma estradiol concentrations are predictive for T-Ch, LDL-Ch and HDL-Ch/TCh ratio, and FTI for LDL-Ch. Regression analyses indicated that while sex steroid hormones may predispose toward atherogenic lipid profile and are predictive for the number and degree of coronary artery stenosis, higher blood level of total testosterone was associated with the lower number of stenosis in the coronary arteries. Hence, endogenous testosterone may have beneficial effect on coronary arteries.