Association between serum estradiol levels and carotid atherosclerosis in middle-aged and elderly men with type 2 diabetes

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Objective To investigate the association between serum estradiol levels and macrovascular complication of atherosclerosis in mid-aged and elderly male patients with type 2 diabetes mellitus (T2DM). Methods One hundred and twenty nine male diabetic patients aged over 45 years were recruited in this study. Serum estriol (E2), testosterone (T) and lipid levels were detected using chemiluminescent immunoassay. Carotid ultrasonography was taken to evaluate macrovascular complication of atherosclerosis. The demographic characteristics, clinical features including duration of diabetes and prevalence of carotid atherosclerosis and biochemical features were compared among patients with different serum E2 levels. Correlation analysis was also performed using binary logistic analysis. Results There were 43 patients with low serum E2 level ( 198.2 pmol/L). Among 129 patients the carotid artery lesions were detected in 64 cases. There were significant differences in body weight [(61.0±10.4), (67.4±13.0)and(76.8±10.5)kg, t=3.40, P=0.00], waist circumference [(81.5±7.9), (86.6±10.7)and(90.0±8.0)cm, t=3.57, P=0.00], body mass index (BMI) [(21.6±3.2), (23.5±3.8)and(26.2±3.0)kg/m2,t=3.72, P=0.00], systolic pressure [(140.2±14.8), (143.9±18.1)and (155.0±13.1)mmHg(1 mmHg=0.133 kPa), t=3.18, P=0.04] and TG [(1.46±0.88), (2.23±1.08)and(3.35±0.9)mmol/L, t=2.66, P=0.04] among patients with low, intermediate and high serum E2 levels. The age-adjusted incidence of carotid atherosclerotic plaque in patients with low, intermediate and high E2 levels were 25.6%(11/43), 56.8%(25/44) and 66.7%(28/42), respectively (χ2=15.73, P=0.00). Compared to low E2 level, the risk ratio of carotid atherosclerosis in intermediate and high E2 levels was 1.60 (95%CI: 1.04-2.46, P<0.05) and 1.80 (95%CI: 1.17-2.76, P<0.05), respectively. Conclusion Serum E2 level is closely associated with carotid atherosclerotic plaque in middle-aged and elderly male type 2 diabetic patients. Key words: Arteriosclorosis, carotid arteries; Testosterone; Diabetes mellitus, type 2; Meddle aged; Aged