TY - JOUR
T1 - Low Serum Testosterone and High Serum Estradiol Associate With Lower Extremity Peripheral Arterial Disease in Elderly Men. The MrOS Study in Sweden
AU - Tivesten, Åsa
AU - Mellström, Dan
AU - Jutberger, Hans
AU - Fagerberg, Björn
AU - Lernfelt, Bodil
AU - Orwoll, Eric
AU - Karlsson, Magnus K.
AU - Ljunggren, Östen
AU - Ohlsson, Claes
N1 - Funding Information:
This work was financially supported by grants from the Swedish Heart and Lung Foundation, the Swedish Research Council, the Novo Nordisk Foundation, the Tore Nilson Foundation, the Emelle Foundation, the Göteborg Medical Society, the ALF/LUA research grant in Göteborg, and the Swedish Medical Society.
PY - 2007/9/11
Y1 - 2007/9/11
N2 - 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 [CI] 1.22 to 2.23, p = 0.001) and free estradiol in the highest quartile (vs. quartiles 1 to 3; OR 1.45, 95% CI 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.
AB - 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 [CI] 1.22 to 2.23, p = 0.001) and free estradiol in the highest quartile (vs. quartiles 1 to 3; OR 1.45, 95% CI 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.
UR - http://www.scopus.com/inward/record.url?scp=34548417939&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34548417939&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2007.04.088
DO - 10.1016/j.jacc.2007.04.088
M3 - Article
C2 - 17825717
AN - SCOPUS:34548417939
SN - 0735-1097
VL - 50
SP - 1070
EP - 1076
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 11
ER -