الفهرس 
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Abstract
Atherosclerosis respects no vascular territory, and its complications can be acute and devastating, as exemplified by myocardial infarction, stroke, or sudden death. Peripheral arterial disease (PAD) is a harbinger of generalized atherosclerosis .and its relentless progression is associated with profound disability, peripheral limb loss, and strong association with coronary and carotid disease.
establish targets for treatment .traditional risk biomarkers for atherosclerosis are well known ,including smoker ,hypertension ,diabetes ,lipid abnormalities ,and family history among others
The ABI reflects the state of arterial perfusion in the lower limb and when measured carefully, is a useful index of peripheral vascular health.
As men aged the serum level of testosterone decrease and serum estradiole and SHBG increase this sex hormones imbalance
in elderly men is the cause of many of symptoms and diseases of agmg.
\:nc pl:c-;;,en\. i\:)-;;’Cl: a\\owa.\ ,no-;;,p\\.a\ \)a-;;,co. -;;,\.~o.’:i \ne\~o.c SO male patient with pad their ages ranged from 65-85 years and 20 apparently health men of matched age without PAD.
All patient and control were subjected to through history taking , complete physical examination ,ABI by Doppler ,abdominal ultrasonography complete blood count, liver function test renal function test lipid profile ,body mass index.
We demonstrated that there is an association between endogenous circulating sex hormones levels and ABI serum testosterone independently and positively associates with ABI suggesting a vascular protective link ,whereas estradiole independently and negatively associates with ABI .a linear regression model showed that the mean ABI values of the study group was inversely proportionate with serum estradiole and SHBG and directly proportionate with serum testosterone and free testosterone and free androgenic index
As regard the result that we obtained In this study we suggested that serum levels of testosterone, estradiole and SHBG that predicts diagnosis of peripheral arterial ischemic disease as follow 2.9nmo1/1 is the best cut off point of serum testosterone ,98 p mo1/1 is the best cut off point of serum estradiole ,78nmo1/1 is the best cut off point of serum SHBG for diagnosis of PAD.