Evaluation of Androgen-Oestrogen Ratio, Anthropometric and Atherogenic Risk Indices in Hypertensives in Port Harcourt, Nigeria

Abstract

Background: Hypertension is associated with anthropometric, hormonal, and lipid abnormalities that may contribute to cardiovascular risk. This study evaluated the androgen-oestrogen ratio, anthropometric indices, and atherogenic risk indices in hypertensive individuals in Port Harcourt, Nigeria. Materials and Methods: A total of 150 subjects were recruited for the study, comprising 75 hypertensive (test) subjects and 75 non-hypertensive (control) subjects. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated using their respective standardised protocols. Testosterone and oestradiol were determined using the enzyme-linked immunosorbent assay (ELISA) method. Total cholesterol (TCHOL), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels were determined using the spectrophotometric enzymatic method. LDL-C was calculated using Friedewald's formula. Castelli risk indices I and II (CRI-I and CRI-II), atherogenic coefficient (AC), non-HDL cholesterol (non-HDL-C), triglyceride-to-HDL-C (TG/HDL-C) ratio, and the atherogenic index of plasma (AIP) were also calculated using their respective standardised protocols. Results: BMI and WHtR were significantly higher (P < 0.05) in the hypertensives compared with the non-hypertensive controls. Testosterone and the testosterone-oestradiol (T/E2) ratio were significantly higher (P < 0.05) in the hypertensives compared with the non-hypertensives. Oestradiol was significantly lower (P < 0.05) in the hypertensive subjects compared with the non-hypertensive controls. TCHOL and LDL-C were significantly higher (P < 0.05) in the hypertensives compared with the non-hypertensives. TG and HDL-C levels were not significantly different (P > 0.05) in the hypertensives compared with the controls. CRI-I, CRI-II, AC, and non-HDL-C were significantly higher (P < 0.05) in the hypertensives compared with the controls. TG/HDL-C and AIP showed no significant differences (P > 0.05) in the hypertensives compared with the controls. Age was negatively correlated with testosterone and oestradiol. BMI, WHtR, and the T/E2 ratio were positively correlated with blood pressure. BMI and WHtR were negatively correlated with the T/E2 ratio. The T/E2 ratio was positively correlated with the atherogenic indices. Conclusion: The T/E2 ratio is a clinically relevant marker of cardiometabolic risk in hypertension. Assessment of the T/E2 ratio rather than the individual sex hormones gives better insight into the hormonal interplay and the balance between androgens and oestrogens in hypertension. The T/E2 ratio should be included in routine clinical checks for screening, as it is a simple and inexpensive biomarker of cardiometabolic risk.