Hormonal Status, Tobacco Addiction, and Coronary Arteriosclerosis in 40- to 60-Year-Old Non-Diabetic Men

Background. Tobacco addiction undoubtedly plays a major role in coronary atherosclerosis formation in men. An age-related decrease in androgenic hormones is probably also involved. Since the coexistence of diabetes dramatically increases cardiovascular risk and mortality from these causes, it is important to study this issue in men without diabetes in assessing the impact of hormonal changes and tobacco consumption on atherogenesis. Objectives. Assessment of impact of hormonal changes and tobacco consumption on artheriosclerosis in the coronary arteries in non-diabetic men aged 40–60. Material and Methods. One hundred two men, including 62 smokers, aged 40–60 years without diabetes in whom angiography due to cardiac indications was performed were involved in the study. From this group, subgroups of patients, 42 with coronary atherosclerosis and 20 without changes in coronary angiography, were established. A control group of 40 healthy men with a negative medical history and normal physical examination and exercise test included 20 smokers and 20 nonsmokers. The concentrations of total and free testosterone, calculated free and bioavailable testosterone, SHBG, DHEAS, E2, IGF-1, GH, and the free androgen index (FAI) were studied in the men. Hormonal status and tobacco addiction parameters were compared with atherogenesis development in the coronary arteries. Results. The presence of atherosclerosis in the coronary arteries correlated with increased tobacco consumption, reduced concentration of free testosterone (assessed by an RIA test), and increased SHBG compared with the men without atherosclerosis. Smokers with atherosclerosis of the coronary arteries also showed lower levels of DHEAS than the healthy smokers and higher LH than the healthy nonsmokers. There were no differences in the mean concentrations of total testosterone, FAI, free and calculated bioavailable testosterone, estradiol, growth hormone, and IGF-1 in the studied groups. No relationship was observed between hormone levels tested with the parameters characterizing tobacco addiction and the degree of coronary occlusion assessed with the number of significantly stenosed vessels and the Gensini score. Conclusions. Coronary atherosclerosis in men is associated with smoking and lower concentrations of free testosterone and DHEAS. Lack of correlation of the other hormone levels with the parameters of tobacco addiction and the degree of vascular occlusion confirmed that the etiology of coronary heart disease is multifactorial (Adv Clin Exp Med 2010, 19, 2, 211–218).