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Objective: The aim of this work is to evaluate the relationship between serum testosterone concentration and carotid
atherosclerosis in elderly males.
Methods: The current study included 40 subjects who were classified into two groups; the first group included 30 elderly
healthy males as the cases group and the second group included 10 young males as the control group. Serum level of total
testosterone was measured using immunoassay kits, sex hormone binding globulin (SHBG) was measured using immunoassay
kits and free androgen index (FAI) was calculated.
Results: Ultra-sonographic measurement of carotid intima-media thickness (IMT). Total testosterone level was significantly
lower in the cases group than control group (t=5.354, p<0.001). SHBG was significantly higher in the cases group than the
control group (t=4.796, p<0.001). Free androgen index (FAI) was significantly lower in cases group than control group
(z=4.686, p<0.001). Intima-Media thickness (IMT) was significantly higher in the cases group than the control group (t=3.513,
p=0.001). As regards the number of plaques 10 males from the cases group did not have any plaques, 13 males had one plaque
and 7 males had two plaques however in the control group 9 males did not have any plaques and only one male, had one
plaque, so cases group had significantly higher prevalence of plaques than the control group (z=3.007, p=0.003). A significant
negative correlation between total testosterone and SHBG (R=-0.856, P<0.001), a significant positive correlation between total
testosterone and FAI (R=0.957, P<0.001), and a significant negative correlation between testosterone and both IMT (R=-0.501,
P=0.005) and number of plaques and (R=-0.358, P=0.52). SHBG was negatively correlated with FAI (R=-0.845, P<0.001) but it
was positively correlated with both IMT (R=0.392, P=0353) and number of plaques (R=0.032, P=0.056). There were significant
negative correlations between FAI and both IMT (R=-0.601, P<0.001) and number of plaques (R=-0.461, P=0.010). IMT was
positively correlated with the number of plaques (R=0.760, P<0.001).
Conclusion: These findings suggest that normal physiologic testosterone levels may help to protect men from the development
of atherosclerosis. In elderly men, low plasma testosterone is associated with elevated carotid intima-media thickness. A
negative correlation has been demonstrated between endogenous testosterone levels and IMT of the carotid arteries. These
findings suggest that men with lower levels of endogenous testosterone may be at a higher risk of developing atherosclerosis.
Nany Hassan Abu Al-Makarim El Gayar is an Assistant Professor of Internal Medicine, Geriatrics Department at Alexandria University, Egypt. He has done MS in Rheumatology and MD in Geriatrics. He has published 10 papers in reputed journals.