Sex hormone metabolism and serum lipids in male survivors of myocardial infarction

Following the injection of tritiated 17 β-estradiol into male survivors of myocardial infarction and men apparently free from complications of atherosclerosis, urine was collected and assayed for estrone, 17 β-estradiol, estriol, and 3H associated with these fractions. Estradiol production rate (E 2PR) was derived. Urinary testosterone, total 17-ketosteroids, serum cholesterol, phospholipid and plasma triglyceride were determined. The survivors of infarction had significantly higher mean cholesterol, phospholipid and total lipid than the controls. No significant difference was observed between the control and infarction groups in the urinary excretion of estrone, estradiol, estriol, testosterone and 17-ketosteroids but the coronary patients had a reduced mean E 2PR. Cholesterol increased with urinary estradiol and E 2PR in the infarction group and with the E2PR/testosterone ratio in the control group. Phospholipid increased with testosterone, estradiol and E 2PR in the infarction group. Triglyceride increased with estriol and the sum of the 3 estrogens in the infarction group and with estrone, estradiol, estrone/testosterone ratio and estradiol/testosterone ratio in the control group. The increased serum lipid levels in the infarction group may have contributed to their coronary sclerosis but no evidence that estrogen tended to normalize the serum lipid pattern was obtained.