The relationship between level of androgenic hormones and coronary artery disease in men

Previous studies have shown controversial results on the role of androgens in coronary artery disease (CAD). We performed this study to assess the relationship between androgen levels and selective coronary angiography (SCA) findings.

This study was conducted on 502 consecutive men who underwent SCA with different indications in our centre. Medical history and blood samples were taken from all subjects prior to angiography. Free testosterone (FREET) was measured with enzyme-linked immunosorbent assay, and total testosterone (TES) plus dehydroepiandrosterone sulfate (DHEA) were checked with radio-immunoassay. Total cholesterol, high- and low-density lipoprotein cholesterol (HDL and LDL), triglycerides, lipoprotein (a) [Lp(a)] and C-reactive protein (CRP) were also tested in all patients. Angiographic results were reported by two cardiologists and checked for intra- and inter-observer reliability, then interpreted as Gensini score, and on the basis of the number of segments involved. The relationships were assessed with the chi-square test, independent sample t-test, one-way analysis of variances, Pearson's correlation, and univariate and multivariate logistic regression tests.

Eighty-three (16.5%) of the subjects had single-vessel disease, 108 (21.5%) had two-vesssel, 197 (39.2%) had three-vessel disease, and 114 (22.7%) had normal angiograms or minimal lesions. FREET, TES and DHEA in patients with significant CAD vs normal individuals were 6.69 +/- 3.20 pg/ml, 16.60 +/- 6.66 nm/l and 113.38 +/- 72.9 microg/dl vs 7.12 +/- 3.58 pg/ml, 15.82 +/- 7.26 nm/l and 109.03 +/- 68.19 microg/ dl, respectively (p > 0.1). There was no correlation between the Gensini score or the number of involved segments and androgen levels. Triglyceride, total cholesterol, LDL and HDL cholesterol levels also had no correlation with androgenic hormones. However, FREET showed a negative correlation with Lp(a) and CRP (p = 0.01, r = -0.12; p = 0.03, r = -0.096, respectively). Moreover, the level of DHEA was lower in diabetics (94.5 +/- 59.19 microg/dl vs 117.97 +/- 74.54 microg/dl, p = 0.004).

There was no significant correlation between FREET, TES, DHEA and the presence or severity of CAD. Also, no correlation was found between androgen levels and triglyceride, total cholesterol, LDL and HDL cholesterol levels.