The American Journal of Medicine
Volume 76, Issue 6 , Pages 1041-1048 , June 1984

Evidence for hyperestrogenemia as the link between diabetes mellitus and myocardial infarction

  • Gerald B. Phillips, M.D.

      Affiliations

    • Corresponding Author InformationRequests for reprints should be addressed to Dr. Gerald B. Phillips, Roosevelt Hospital, 428 West 59th Street, New York, New York 10019.
    • From the Department of Medicine, Columbia University College of Physicians and Surgeons, St. Luke's-Roosevelt Hospital Center, New York, New York.

,Accepted 3 February 1984.

References 

  1. Garcia MJ, McNamara PM, Gordon T, Kannel WB. Morbidity and mortality in diabetes in the Framingham population. Sixteen year follow-up study. Diabetes. 1974;23:105–111
  2. Kannel WB, McGee DL. Diabetes and cardiovascular disease. The Framingham study. JAMA. 1979;241:2035–2038
  3. Pirart J. Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients observed between 1947 and 1973. Diabetes Care. 1978;1:168–188Pirart J. Diabetes mellitus and its degenerative complications: a prospective study of 4,400 patients observed between 1947 and 1973. Diabetes Care. 1978;1:252–263
  4. Waller BF, Palumbo PJ, Roberts WC. Status of the coronary arteries at necropsy in diabetes mellitus with onset after age 30 years. Am J Med. 1980;69:498–506
  5. Vigorita VJ, Moore GW, Hutchins GM. Absence of correlation between coronary arterial atherosclerosis and severity or duration of diabetes mellitus of adult onset. Am J Cardiol. 1980;46:535–542
  6. University Group Diabetes Program. Effects of hypoglycemic agents on vascular complications in patients with adultonset diabetes. Diabetes. 1982;31(suppl 5):1–81
  7. Nikkilä EA, Hormila P. Serum lipids and lipoproteins in insulin-treated diabetes. Diabetes. 1978;27:1078–1086
  8. Phillips GB. Evidence for hyperoestrogenaemia as a risk factor for myocardial infarction in men. Lancet. 1976;II:14–18
  9. Phillips GB. Relationship between serum sex hormones and glucose, insulin, and lipid abnormalities in men with myocardial infarction. In: 2nd ed. Proc Natl Acad Sci USA. 74:1977;p. 1729–1733
  10. Phillips GB. Sex hormones, risk factors and cardiovascular disease. Am J Med. 1978;65:7–11
  11. National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes. 1979;28:1039–1057
  12. Phillips GB, Castelli WP, Abbott RD, McNamara PM. Association of hyperestrogenemia and coronary heart disease in men in the Framingham cohort. Am J Med. 1983;74:863–869
  13. Murphy BEP. Some studies of the protein-binding of steroids and their application to the routine micro and ultramicro measurement of various steroids in body fluids by competitive protein-binding radioassay. J Clin Endocrinol. 1967;27:973–990
  14. Fuller JH, Shipley MJ, Rose G, Jarrett RJ, Keen H. Coronaryheart-disease risk and impaired glucose tolerance. The Whitehall study. Lancet. 1980;I:1373–1376
  15. Pirke KM, Doerr P. Age related changes and interrelationships between plasma testosterone, oestradiol, and testosterone-binding globulin in normal adult males. Acta Endocrinol (Copenh). 1973;74:792–800
  16. Wahlberg F. Intravenous glucose tolerance in myocardial infarction, angina pectoris and intermittent claudication. Acta Med Scand. 1966;453:1–93suppl
  17. Christiansen I, Deckert T, Kjerulf K, Midtgaard K, Worning H. Glucose tolerance, plasma lipids and serum insulin in patients with ischaemic heart diseases. Acta Med Scand. 1968;184:283–287
  18. Hatch FT, Reissell PK, Poon-King TMW, Canellos GP, Lees RS, Hagopian LM. A study of coronary heart disease in young men. Circulation. 1966;33:679–703
  19. Schneider G, Kirschner MA, Berkowitz R, Ertel NH. Increased estrogen production in obese men. J Clin Endocrinol Metab. 1979;48:633–638
  20. Kley HK, Solbach HG, McKinnan JC, Krüskemper HL. Testosterone decrease and oestrogen increase in male patients with obesity. Acta Endocrinol (Copenh). 1979;91:553–563
  21. Stanik S, Dornfeld LP, Maxwell MH, Viosca SP, Korenman SG. The effect of weight loss on reproductive hormones in obese men. J Clin Endocrinol Metab. 1981;53:828–832
  22. Spellacy WN, Buhi WC, Spellacy CE, Mosses LE, Goldzieher JW. Glucose, insulin, and growth hormone studies in long-term users of oral contraceptives. Am J Obstet Gynecol. 1970;106:173–182
  23. Mann JI, Vessey MP, Thorogood M, Doll R. Myocardial infarction in young women with special reference to oral contraceptive practice. Br Med J. 1975;2:241–245
  24. O'Sullivan JB. Body weight and subsequent diabetes mellitus. JAMA. 1982;248:949–952
  25. Goodkin G. Mortality factors in diabetes. J Occup Med. 1975;17:716–721
  26. Gluud C, Madsbad S, Krarup T, Bennett P. Plasma testosterone and androstenedione in insulin dependent patients at time of diagnosis and during the first year of insulin treatment. Acta Endocrinol (Copenh). 1982;100:406–409
  27. Longcope C, Kato T, Horton R. Conversion of blood androgens to estrogens in normal adult men and women. J Clin Invest. 1969;48:2191–2201
  28. Macdonald PC, Madden JD, Brenner PF, Wilson JD, Siiteri PK. Origin of estrogen in normal men and in women with testicular feminization. J Clin Endocrinol Metab. 1979;49:905–916
  29. Meneely GR, Heyssel RM, Ball COT, et al. Analysis of factors affecting body composition determined from potassium content in 915 normal subjects. Ann NY Acad Sci. 1963;110:271–281
  30. Nilsson A, Almgren PE. Psychiatric symptoms during the post-partum period as related to use of oral contraceptives. Br Med J. 1968;2:453–455
  31. Taggart NR, Holliday RM, Billewicz WZ, Hytten FE, Thomson AM. Changes in skinfolds during pregnancy. Br J Nutr. 1967;21:438–451
  32. Paul O. Epidemiology of hypertension. In:  Genest J,  Kiow E,  Kuchel O editor. Hypertension. New York: McGraw-Hill; 1977;p. 613–630
  33. New MI, Roberts TN, Bierman EL, Reader GG. The significance of blood lipid alterations in diabetes mellitus. Diabetes. 1963;12:208–212
  34. Nilsén R, Persson G. Smoking habits in diabetics. Lancet. 1972;I:1283–1284
  35. Berglund G, Larsson B, Anderson O, et al. Body composition and glucose metabolism in hypertensive middle-aged males. Acta Med Scand. 1976;200:163–169
  36. Jarrett RJ, Keen H, McCartney M, et al. Glucose tolerance and blood pressure in two population samples: their relation to diabetes mellitus and hypertension. Int J Epidemiol. 1978;7:15–24
  37. Welborn TA, Breckenridge A, Rubinstein AH, Dollery CT, Fraser TR. Serum-insulin in essential hypertension and in peripheral vascular disease. Lancet. 1966;I:1336–1337
  38. Doll R, Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976;2:1525–1536
  39. Cramér K, Paulin S, Werkö L. Coronary angiographic findings in correlation with age, body weight, blood pressure, serum lipids, and smoking habits. Circulation. 1966;33:888–900
  40. Gordon T, Kannel WE. Predisposition to atherosclerosis in the head, heart, and legs. JAMA. 1972;221:661–666
  41. Russ EM, Eder HA, Barr DP. Influence of gonadal hormones on protein-lipid relationships in human plasma. Am J Med. 1955;19:4–24
  42. Kolodny RC, Kahn CB, Goldstein HH, Barnett DM. Sexual dysfunction in diabetic men. Diabetes. 1974;23:306–309
  43. Deutsch S, Sherman L. Previously unrecognized diabetes mellitus in sexually impotent men. JAMA. 1980;244:2430–2432
  44. Jensen SB, Hagen C, Frøland A, Pedersen PB. Sexual function and pituitary axis in insulin treated diabetic men. Acta Med Scand. 1979;624:65–68suppl
  45. Heaton KW. The epidemiology of gallstones and suggested aetiology. Clin Gastroenterol. 1973;2:67–83
  46. Coronary Drug Project Research Group. Gallbadder disease as a side effect of drugs influencing lipid metabolism. N Engl J Med. 1977;296:1185–1190
  47. Boston Collaborative Drug Surveillance Program . Surgically confirmed gallbadder disease, venous thromboembolism and breast tumors in relation to postmenopausal estrogen therapy. N Engl J Med. 1974;290:15–19
  48. Phillips GB, Safrit HF. Alcoholic diabetes. Induction of glucose intolerance with alcohol. JAMA. 1971;217:1513–1519
  49. Gordon GG, Altman K, Southren AL, Rubin E, Lieber CS. Effect of alcohol (ethanol) administration on sex-hormone metabolism in normal men. N Engl J Med. 1976;295:793–797

☆ This work was supported in part by Grant HL-20645 from the National Institutes of Health, U.S. Public Health Service.

PII: 0002-9343(84)90855-6

The American Journal of Medicine
Volume 76, Issue 6 , Pages 1041-1048 , June 1984

Article Tools