Nelson Vergel
Founder, ExcelMale.com
Am J Respir Crit Care Med. 2015 Dec 10. [Epub ahead of print]
Higher Estradiol and Lower Dehydroepiandrosterone-Sulfate Levels Are Associated With Pulmonary Arterial Hypertension in Men.
Ventetuolo CE1, Baird GL2, Barr RG3, Bluemke DA4, Fritz JS5, Hill NS6, Klinger JR7, Lima JA8, Ouyang P9, Palevsky HI10, Palmisciano AJ11, Krishnan I12, Pinder D13, Preston IR14, Roberts KE15, Kawut SM16.
Abstract
RATIONALE:
Recent studies have focused on the role of female sex and estradiol (E2) in pulmonary arterial hypertension (PAH), but it is not known whether sex hormones are risk factors for PAH in men.
OBJECTIVES:
We performed a case-control study to determine whether hormone levels (E2, dehydroepiandrosterone-sulfate [DHEA-S], and testosterone) are associated with PAH in men.
METHODS:
Plasma sex hormone levels in men with idiopathic, heritable, or connective tissue disease-associated PAH were compared to those from age- and body mass index-matched men without clinical cardiovascular disease.
MEASUREMENTS AND MAIN RESULTS:
There were 23 cases with PAH (70% had idiopathic PAH, 65% were functional class III/IV) and 67 controls. Higher E2 and E2:testosterone levels were associated with the risk of PAH (OR per 1 ln[E2:testosterone] = 6.0, 95% CI 2.2 - 16.4, p = 0.001) while higher levels of DHEA-S were associated with a reduced risk (OR per 1 ln[DHEA-S] = 0.1, 95% CI 0.0 - 0.3, p = 0.001). E2 and DHEA-S levels were strong predictors of case status (c-statistic for both 0.82) but testosterone was not (c-statistic 0.53). Higher levels of E2 were associated with shorter six-minute walk distances (p = 0.03) whereas higher levels of DHEA-S were associated with lower right atrial pressure (p = 0.02) and pulmonary vascular resistance (p = 0.01) in men with PAH.
CONCLUSIONS:
Higher levels of E2 and lower levels of DHEA-S were associated with PAH in men. Sex-based differences in sex hormone processing and signaling may contribute to unique phenotypes in pulmonary vascular disease.
Higher Estradiol and Lower Dehydroepiandrosterone-Sulfate Levels Are Associated With Pulmonary Arterial Hypertension in Men.
Ventetuolo CE1, Baird GL2, Barr RG3, Bluemke DA4, Fritz JS5, Hill NS6, Klinger JR7, Lima JA8, Ouyang P9, Palevsky HI10, Palmisciano AJ11, Krishnan I12, Pinder D13, Preston IR14, Roberts KE15, Kawut SM16.
Abstract
RATIONALE:
Recent studies have focused on the role of female sex and estradiol (E2) in pulmonary arterial hypertension (PAH), but it is not known whether sex hormones are risk factors for PAH in men.
OBJECTIVES:
We performed a case-control study to determine whether hormone levels (E2, dehydroepiandrosterone-sulfate [DHEA-S], and testosterone) are associated with PAH in men.
METHODS:
Plasma sex hormone levels in men with idiopathic, heritable, or connective tissue disease-associated PAH were compared to those from age- and body mass index-matched men without clinical cardiovascular disease.
MEASUREMENTS AND MAIN RESULTS:
There were 23 cases with PAH (70% had idiopathic PAH, 65% were functional class III/IV) and 67 controls. Higher E2 and E2:testosterone levels were associated with the risk of PAH (OR per 1 ln[E2:testosterone] = 6.0, 95% CI 2.2 - 16.4, p = 0.001) while higher levels of DHEA-S were associated with a reduced risk (OR per 1 ln[DHEA-S] = 0.1, 95% CI 0.0 - 0.3, p = 0.001). E2 and DHEA-S levels were strong predictors of case status (c-statistic for both 0.82) but testosterone was not (c-statistic 0.53). Higher levels of E2 were associated with shorter six-minute walk distances (p = 0.03) whereas higher levels of DHEA-S were associated with lower right atrial pressure (p = 0.02) and pulmonary vascular resistance (p = 0.01) in men with PAH.
CONCLUSIONS:
Higher levels of E2 and lower levels of DHEA-S were associated with PAH in men. Sex-based differences in sex hormone processing and signaling may contribute to unique phenotypes in pulmonary vascular disease.
