Influence of endogenous androgens on carotid wall in postmenopausal women

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.