男性血中エストロジェンと頸動脈内膜中膜肥厚の関連

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The role of estrogen for atherosclerotic cardiovascular disease is controversial. In order to examine the role of endogenous estrogens for atherosclerotic disease in men, we investigated the association of estradiol and bioavailable estradiol with intimalmedial thickness of the common carotid artery and various atherosclerotic risk factors in apparently healthy men. The study subjects were 351 healthy men with a mean age and body mass index of 50.8yr and 23.4kg/m^2. Serum lipids, glucose insulin, estradiol and sex hormone binding globulin (SHBG) were measured. Bioavailable estradiol was calculated from the values of estradiol, SHBG and serum albumin. Intimal-medial thickness (IMT) of common carotid artery was measured by B-mode ultrasound. Abdominal subcutaneous (ASF) and intraabdominal fat (IAF) area by CT scan were measured. Correlation coefficients were calculated by Spearman's rank correlation. There were positive correlations of carotid IMT with serum estradiol and bioavailable estradiol before and after adjustment for variables which themselves showed correlations with carotid IMT including age, BMI, glucose tolerance, fasting plasma insulin, HDL-cholesterol and systolic blood pressure. Among atherosclerotic factors tested only fasting plasma glucose showed a weak but significant correlation with serum estradiol. On the other hand, IAF, fasting plasma glucose and triglyceride were correlated with bioavailable estradiol. These results indicate that serum estrogen in men is associated with early carotid atherosclerosis independent of conventional atherosclerotic risk factors. Although cause-effect relation is not known, the association observed in this study does not support widely believed cardioprotective effects of estrogen.
2003-03-31

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