Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC1795410.15690/vramn17954CARDIOLOGY AND CARDIOVASCULAR SURGERY: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ КАРДИОЛОГИИ И СЕРДЕЧНО-СОСУДИСТОЙ ХИРУРГИИResearch ArticleEstradiol Level as a Risk Factor for Cardiovascular Endpoints in Men: A Systematic ReviewСвязь уровня эстрадиола с сердечно-сосудистыми осложнениями у мужчин по данным систематического обзораhttps://orcid.org/0000-0002-8160-56123153-8373OrlovaIana A.ОрловаЯна Артуровна
Russian Federation

MD, PhD, Professor

д.м.н., профессор

YAOrlova@mc.msu.ruhttps://orcid.org/0009-0002-5730-4286SorokinEgor D.СорокинЕгор Дмитриевич
Russian Federation
srknegor@gmail.comhttps://orcid.org/0000-0001-7954-04379329-7628PavlovaZukhra Sh.ПавловаЗухра Шариповна
Russian Federation

MD, PhD

д.м.н.

zukhra73@gmail.comhttps://orcid.org/0000-0003-2015-47123541-2077PlisyukAlina G.ПлисюкАлина Геннадьевна
Russian Federation

MD, PhD, Associate Professor

к.м.н., доцент

apl.cardio@yandex.ruhttps://orcid.org/0000-0003-4251-75456609-5468KamalovArmais A.КамаловАрмаис Альбертович
Russian Federation

MD, PhD, Professor, Academician of the RAS

д.м.н., профессор, академик РАН

AAKamalov@mc.msu.ruLomonosov Moscow State UniversityМосковский государственный университет имени М.В. Ломоносова150820247932052152602202413052024Copyright ©; 2024, "Paediatrician" Publishers LLCCopyright ©; 2024, Издательство "Педиатръ"2024"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/article/view/17954

Cardiovascular disease is a major cause of higher mortality of middle-aged and elderly males in comparison to women. Sex hormones action on cardiovascular system is the most likely explanation of this differences. Nevertheless, estradiol and cardiovascular disease relationship is still unclear. The authors conducted a systematic review to identify the association of endogenous estradiol with cardiovascular endpoints in men. Articles were identified by a MedLine search (1961 — July 2023) and citation tracking. No evidence synthesis was conducted. 24 eligible articles were found. In 10 studies no association of sex hormones and endpoints was found. In 7 studies there was an association of testosterone and endpoints, but no significant results for estradiol. 7 studies have reported significant association of estradiol and cardiovascular endpoints. Inconsistency in evidence is significantly influenced by differences between studies in patient age, follow-up, researched endpoints and quality of estradiol essay. Over 40% of published studies, that researched the association of estradiol and death, found such a link. However, existing body of literature is largely heterogenous and doesn’t provide definite evidence for a pronounced net effect of estradiol on cardiovascular health in general men population. The present systematic review hints, that endogenous estradiol could be linked with cardiovascular risks in white men of young and middle age.

Сердечно-сосудистые заболевания (ССЗ) определяют более высокую смертность мужчин среднего и пожилого возраста по сравнению с женщинами. Действие половых гормонов на сердечно-сосудистую систему является наиболее вероятным механизмом этих различий. При этом роль эстрадиола в патофизиологии ССЗ до сих пор не определена. Проведен экстенсивный поиск публикаций в системе MedLine (1961 — июль 2023 г.) с использованием ключевых слов «эстрадиол», «сердечно-сосудистые заболевания», «мужчины», «люди». Методы синтеза не использовались. 24 публикации соответствовало критериям поиска. В 10 исследованиях не было обнаружено связи между уровнями половых гормонов и конечными событиями. В 7 исследованиях найдена ассоциация тестостерона с конечными точками, но не было получено значимых результатов по эстрадиолу. Было выявлено 7 исследований, в которых найдена ассоциация эстрадиола с конечными точками. На различия в опубликованных результатах значимо влияли возраст пациентов, метод определения эстрадиола, дизайн исследования, его длительность и конечные точки. Более 40% опубликованных работ, в которых изучалась ассоциация уровня эстрадиола со смертностью, выявило наличие такой связи. Однако гетерогенность опубликованных данных не позволяет сделать окончательные выводы о влиянии уровня эстрадиола на сердечно-сосудистые риски в мужской популяции в целом. Проведенный нами анализ показывает, что с наибольшей вероятностью уровень эстрадиола может быть ассоциирован с риском развития болезней системы кровообращения у белых мужчин молодого и среднего возраста.

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