Objective: There is increasing evidence of a direct association between nor
mal androgen levels and reduced cardiovascular morbidity and mortality in w
omen. After menopause the influence of estrogens declines, whereas that of
androgens increases. Therefore, we investigated the effects of androgens on
atherosclerosis in postmenopausal women, by using carotid artery intimal-m
edial thickness as a marker of vascular damage.
Design: Blood pressure, body mass index, waist-to-hip ratio, serum dehydroe
piandrosterone sulfate, androstenedione, total and free testosterone, estro
ne, insulin, lipid profile, and glucose were evaluated in 44 women in stabl
e physiological menopause. All subjects underwent carotid ultrasound (Bioso
und 2000 II s.a. high-resolution unit).
Results: Spearman correlation coefficients indicated that serum androstened
ione and fi-ee testosterone were negatively associated with several carotid
intimal-medial thickness measures with correlation coefficients (r) rangin
g from 0.477 to 0.397 (p < 0.01-0.04). Moreover, age-adjusted androstenedio
ne and free testosterone highest tertiles showed intimal-medial thickness v
alues significantly (p < 0.03-0.05) lower than the other tertiles. There wa
s a favorable association between hormones and the most important cardiovas
cular risk factors. This association, however, did not reach statistical si
gnificance. Stepwise multiple regression analysis showed that the inverse r
elationships between the hormones (androstenedione and free testosterone) a
nd several intimal-medial thickness measures were maintained (F: 4.15-6.07,
p < 0.05-0.02) after adjustment for major cardiovascular risk factors.
Conclusions: Our data demonstrate that in postmenopausal women endogenous s
teroid precursors and androgens are inversely related to carotid intimal-me
dial thickness, an established marker of atherosclerosis. In addition, thes
e hormones show favorable associations with cardiovascular risk factors. Th
erefore, our study suggests that, after menopause, normal androgen levels m
ay benefit the carotid artery wall.