Serum DHEA and Testosterone Levels Associate Inversely with Coronary Artery Calcification in Elderly Men

Asa Tivesten; Vilmundur Gudnason; Sigurdur Sigurdsson; Claes Ohlsson; Thor Aspelund; Matti Poutanen

doi:10.1210/clinem/dgad351

Serum DHEA and Testosterone Levels Associate Inversely with Coronary Artery Calcification in Elderly Men

Asa Tivesten, Vilmundur Gudnason, Sigurdur Sigurdsson, Claes Ohlsson, Thor Aspelund, Matti Poutanen

Faculty of Medicine

Research output: Other contribution

Abstract

CONTEXT: Epidemiological and preclinical data support cardiovascular, mainly protective, effects of sex steroids in men, but the mechanisms underlying the cardiovascular actions of sex steroids are poorly understood. Vascular calcification parallels the development of atherosclerosis, but is increasingly recognized as a diversified, highly regulated process, which itself may have pathophysiological importance for clinical cardiovascular events. OBJECTIVE: To investigate the association between serum sex steroids and coronary artery calcification (CAC) in elderly men. METHODS: We used gas chromatography tandem mass spectrometry to analyze a comprehensive sex steroid profile, including levels of dehydroepiandrosterone (DHEA), androstenedione, estrone, testosterone, estradiol, and dihydrotestosterone, in men from the population-based AGES-Reykjavik study (n = 1287, mean 76 years). Further, sex hormone-binding globulin (SHBG) was assayed and bioavailable hormone levels calculated. CAC score was determined by computed tomography. The main outcome measures were cross-sectional associations between dehydroepiandrosterone, androstenedione, estrone, testosterone, dihydrotestosterone, and estradiol and quintiles of CAC. RESULTS: Serum levels of DHEA, androstenedione, testosterone, dihydrotestosterone, and bioavailable testosterone showed significant inverse associations with CAC, while estrone, estradiol, bioavailable estradiol, and SHBG did not. DHEA, testosterone, and bioavailable testosterone remained associated with CAC after adjustment for traditional cardiovascular risk factors. In addition, our results support partially independent associations between adrenal-derived DHEA and testes-derived testosterone and CAC. CONCLUSION: Serum levels of DHEA and testosterone are inversely associated with CAC in elderly men, partially independently from each other. These results raise the question whether androgens from both the adrenals and the testes may contribute to male cardiovascular health.

Original language	English
Number of pages	8
Edition	12
Volume	108
DOIs	https://doi.org/10.1210/clinem/dgad351
Publication status	Published - 17 Nov 2023

Publication series

Name	The Journal of Clinical Endocrinology & Metabolism
ISSN (Print)	0021-972X

Bibliographical note

Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society.

Other keywords

atherosclerosis
coronary artery calcification
men
sex steroids

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10.1210/clinem/dgad351Licence: CC BY-NC-ND

Cite this

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title = "Serum DHEA and Testosterone Levels Associate Inversely with Coronary Artery Calcification in Elderly Men",

abstract = "CONTEXT: Epidemiological and preclinical data support cardiovascular, mainly protective, effects of sex steroids in men, but the mechanisms underlying the cardiovascular actions of sex steroids are poorly understood. Vascular calcification parallels the development of atherosclerosis, but is increasingly recognized as a diversified, highly regulated process, which itself may have pathophysiological importance for clinical cardiovascular events. OBJECTIVE: To investigate the association between serum sex steroids and coronary artery calcification (CAC) in elderly men. METHODS: We used gas chromatography tandem mass spectrometry to analyze a comprehensive sex steroid profile, including levels of dehydroepiandrosterone (DHEA), androstenedione, estrone, testosterone, estradiol, and dihydrotestosterone, in men from the population-based AGES-Reykjavik study (n = 1287, mean 76 years). Further, sex hormone-binding globulin (SHBG) was assayed and bioavailable hormone levels calculated. CAC score was determined by computed tomography. The main outcome measures were cross-sectional associations between dehydroepiandrosterone, androstenedione, estrone, testosterone, dihydrotestosterone, and estradiol and quintiles of CAC. RESULTS: Serum levels of DHEA, androstenedione, testosterone, dihydrotestosterone, and bioavailable testosterone showed significant inverse associations with CAC, while estrone, estradiol, bioavailable estradiol, and SHBG did not. DHEA, testosterone, and bioavailable testosterone remained associated with CAC after adjustment for traditional cardiovascular risk factors. In addition, our results support partially independent associations between adrenal-derived DHEA and testes-derived testosterone and CAC. CONCLUSION: Serum levels of DHEA and testosterone are inversely associated with CAC in elderly men, partially independently from each other. These results raise the question whether androgens from both the adrenals and the testes may contribute to male cardiovascular health.",

keywords = "atherosclerosis, coronary artery calcification, men, sex steroids",

author = "Asa Tivesten and Vilmundur Gudnason and Sigurdur Sigurdsson and Claes Ohlsson and Thor Aspelund and Matti Poutanen",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society.",

year = "2023",

month = nov,

day = "17",

doi = "10.1210/clinem/dgad351",

language = "English",

volume = "108",

series = "The Journal of Clinical Endocrinology & Metabolism",

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TY - GEN

T1 - Serum DHEA and Testosterone Levels Associate Inversely with Coronary Artery Calcification in Elderly Men

AU - Tivesten, Asa

AU - Gudnason, Vilmundur

AU - Sigurdsson, Sigurdur

AU - Ohlsson, Claes

AU - Aspelund, Thor

AU - Poutanen, Matti

PY - 2023/11/17

Y1 - 2023/11/17

N2 - CONTEXT: Epidemiological and preclinical data support cardiovascular, mainly protective, effects of sex steroids in men, but the mechanisms underlying the cardiovascular actions of sex steroids are poorly understood. Vascular calcification parallels the development of atherosclerosis, but is increasingly recognized as a diversified, highly regulated process, which itself may have pathophysiological importance for clinical cardiovascular events. OBJECTIVE: To investigate the association between serum sex steroids and coronary artery calcification (CAC) in elderly men. METHODS: We used gas chromatography tandem mass spectrometry to analyze a comprehensive sex steroid profile, including levels of dehydroepiandrosterone (DHEA), androstenedione, estrone, testosterone, estradiol, and dihydrotestosterone, in men from the population-based AGES-Reykjavik study (n = 1287, mean 76 years). Further, sex hormone-binding globulin (SHBG) was assayed and bioavailable hormone levels calculated. CAC score was determined by computed tomography. The main outcome measures were cross-sectional associations between dehydroepiandrosterone, androstenedione, estrone, testosterone, dihydrotestosterone, and estradiol and quintiles of CAC. RESULTS: Serum levels of DHEA, androstenedione, testosterone, dihydrotestosterone, and bioavailable testosterone showed significant inverse associations with CAC, while estrone, estradiol, bioavailable estradiol, and SHBG did not. DHEA, testosterone, and bioavailable testosterone remained associated with CAC after adjustment for traditional cardiovascular risk factors. In addition, our results support partially independent associations between adrenal-derived DHEA and testes-derived testosterone and CAC. CONCLUSION: Serum levels of DHEA and testosterone are inversely associated with CAC in elderly men, partially independently from each other. These results raise the question whether androgens from both the adrenals and the testes may contribute to male cardiovascular health.

AB - CONTEXT: Epidemiological and preclinical data support cardiovascular, mainly protective, effects of sex steroids in men, but the mechanisms underlying the cardiovascular actions of sex steroids are poorly understood. Vascular calcification parallels the development of atherosclerosis, but is increasingly recognized as a diversified, highly regulated process, which itself may have pathophysiological importance for clinical cardiovascular events. OBJECTIVE: To investigate the association between serum sex steroids and coronary artery calcification (CAC) in elderly men. METHODS: We used gas chromatography tandem mass spectrometry to analyze a comprehensive sex steroid profile, including levels of dehydroepiandrosterone (DHEA), androstenedione, estrone, testosterone, estradiol, and dihydrotestosterone, in men from the population-based AGES-Reykjavik study (n = 1287, mean 76 years). Further, sex hormone-binding globulin (SHBG) was assayed and bioavailable hormone levels calculated. CAC score was determined by computed tomography. The main outcome measures were cross-sectional associations between dehydroepiandrosterone, androstenedione, estrone, testosterone, dihydrotestosterone, and estradiol and quintiles of CAC. RESULTS: Serum levels of DHEA, androstenedione, testosterone, dihydrotestosterone, and bioavailable testosterone showed significant inverse associations with CAC, while estrone, estradiol, bioavailable estradiol, and SHBG did not. DHEA, testosterone, and bioavailable testosterone remained associated with CAC after adjustment for traditional cardiovascular risk factors. In addition, our results support partially independent associations between adrenal-derived DHEA and testes-derived testosterone and CAC. CONCLUSION: Serum levels of DHEA and testosterone are inversely associated with CAC in elderly men, partially independently from each other. These results raise the question whether androgens from both the adrenals and the testes may contribute to male cardiovascular health.

KW - atherosclerosis

KW - coronary artery calcification

KW - men

KW - sex steroids

UR - http://www.scopus.com/inward/record.url?scp=85177102515&partnerID=8YFLogxK

U2 - 10.1210/clinem/dgad351

DO - 10.1210/clinem/dgad351

M3 - Other contribution

C2 - 37391895

VL - 108

T3 - The Journal of Clinical Endocrinology & Metabolism

ER -

Serum DHEA and Testosterone Levels Associate Inversely with Coronary Artery Calcification in Elderly Men

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