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Endogenous Androgens and Carotid Intimal-Medial Thickness in Women

Department of Internal Medicine (G.P.B., M.S., A.M., G.F.A., C.O.B., A.S.) and Department of Experimental Pathology (R.C.), Medical Biotechnology, Infertility and Epidemiology, and Institute of Clinical Physiology C.N.R., University of Pisa, 56100 Pisa, Italy

Address correspondence and requests for reprints to: Dr. Giampaolo Bernini, Dipartimento di Medicina Interna, University of Pisa, Via Roma 67, 56100 Pisa, Italy.

The influence of endogenous androgens on atherosclerotic disease in women is unknown. In this study involving 101 pre- and postmenopausal females, we evaluated the relationship between serum androgen levels and both carotid artery intimal-medial thickness (IMT) and major cardiovascular risk factors. In addition to evaluation of blood pressure, body mass index, and waist-to-hip ratio, serum dehydroepiandrosterone sulfate (DHEA-S), androstenedione (A), total testosterone (TTS), free testosterone (FTS), insulin, cholesterol (total and high density lipoproteins), triglycerides, and glucose were measured. All women underwent carotid ultrasonography. Spearman correlation coefficients showed that serum DHEA-S and A levels were negatively related (P < 0.03–0.0004) to several IMT measures. Higher tertiles of DHEA-S, A, and FTS corresponded to significantly lower measures of carotid thickness. DHEA-S, and all androgens were inversely related to age (P < 0.03 or less), showing no unfavorable association with major cardiovascular risk factors. In contrast, serum DHEA-S was negatively associated with WHR (P < 0.02), while A was negatively associated with body mass index (P < 0.02). Stepwise multiple regression analysis indicated that A and FTS showed an inverse association with IMT measures (P < 0.05–0.001).

In conclusion, our data indicate that in women serum DHEA-S and androgens decline with age and that normal hormonal levels are not associated with major cardiovascular risk factors. They also show that higher DHEA-S and androgen concentrations are related to lower carotid wall thickness; for A this association is independent of cardiovascular risk factors. Our results suggest that, in the physiological range, DHEA-S and androgens in women are correlated with lower risk of carotid artery atherosclerosis.

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