Endogenous Sex Hormones and Incident Cardiovascular Disease in Post-Menopausal Women.
Endogenous Sex Hormones and Incident Cardiovascular Disease in Post-Menopausal Women.
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DOI：
10.1016/j.jacc.2018.01.083
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发表时间：
2018-06-05
影响因子：
24
通讯作者：
Michos ED
中科院分区：
文献类型：
--
作者：
Zhao D;Guallar E;Ouyang P;Subramanya V;Vaidya D;Ndumele CE;Lima JA;Allison MA;Shah SJ;Bertoni AG;Budoff MJ;Post WS;Michos ED
较高的雄激素和较低的雌激素水平与女性心血管疾病（CVD）的危险因素有关。然而，关于女性性激素和心血管事件的研究产生了相互矛盾的结果。我们评估了基线时无心血管疾病的女性性激素水平与心血管疾病、冠心病（CHD）和心力衰竭（HF）事件的关系。我们研究了2,834名绝经后妇女参加梅萨与睾酮，雌二醇，脱氢表雄酮，和性激素结合球蛋白（SHBG）水平测量的基线（2000-2002年）。我们使用考克斯风险模型来评估性激素与每个结果的相关性，调整人口统计学，CVD危险因素和激素治疗的使用。平均（SD）年龄为64.9（8.9）岁。在12.1年的随访中，发生了283例CVD、171例CHD和103例HF事件。在多变量校正模型中，CVD、CHD和HF各自结局的性激素水平对数转换值大于1 SD相关的风险比（95% CI）如下：总睾酮：1.14（1.01-1.29）、1.20（1.03-1.40）、1.09（0.90-1.34）; E2：0.94（0.80-1.11）、0.77（0.63-0.95）、0.78（0.60-1.02）; TeCl 4/ECl 4比值：1.19（1.02-1.40）、1.45（1.19-1.78）、1.31（1.01-1.70）。脱氢表雄酮和SHBG水平与这些结果无关。在绝经后妇女中，较高的睾酮/雌二醇比值与CVD、CHD和HF事件发生风险升高相关，较高水平的睾酮与CVD和CHD增加相关，而较高水平的雌二醇与较低的CHD风险相关。绝经后的性激素水平与女性以后生活中心血管疾病风险增加有关。我们在动脉粥样硬化的多种族研究中研究了2,834名绝经后妇女。较高的总睾酮/雌二醇比值与CVD、CHD和HF事件发生风险升高独立相关。在>12年的随访后，CVD、CHD和HF事件的多变量校正风险比（95%CI）分别为1.19（1.02-1.40）、1.45（1.19-1.78）、1.31（1.01-1.70）。绝经后的性激素水平与女性以后生活中心血管疾病风险增加有关。
Higher androgen and lower estrogen levels are associated with cardiovascular disease (CVD) risk factors in women. However, studies on sex hormones and incident CVD events in women have yielded conflicting results. We assessed the associations of sex hormone levels with incident CVD, coronary heart disease (CHD), and heart failure (HF) events among women without CVD at baseline. We studied 2,834 post-menopausal women participating in MESA with testosterone, estradiol, dehydroepiandrosterone, and sex hormone binding globulin (SHBG) levels measured at baseline (2000–2002). We used Cox hazard models to evaluate associations of sex hormones with each outcome, adjusting for demographics, CVD risk factors, and hormone therapy use. The mean (SD) age was 64.9 (8.9) years. During 12.1 years of follow-up, 283 CVD, 171 CHD, and 103 HF incident events occurred. In multivariable-adjusted models, the Hazard Ratios (95% CI) associated with 1 SD greater log-transformed sex hormone level for the respective outcomes of CVD, CHD, and HF were as follows: Total testosterone: 1.14 (1.01–1.29), 1.20 (1.03–1.40), 1.09 (0.90–1.34); Estradiol: 0.94 (0.80–1.11), 0.77 (0.63–0.95), 0.78 (0.60–1.02); Testosterone/Estradiol ratio: 1.19 (1.02–1.40), 1.45 (1.19–1.78), 1.31 (1.01–1.70). Dehydroepiandrosterone and SHBG levels were not associated with these outcomes. Among post-menopausal women, a higher testosterone/estradiol ratio was associated with an elevated risk for incident CVD, CHD, and HF events, higher levels of testosterone associated with increased CVD and CHD, while higher estradiol levels were associated with a lower CHD risk. Sex hormones levels after menopause are associated with women’s increased CVD risk later in life. We studied 2,834 post-menopausal women in the Multi-Ethnic Study of Atherosclerosis. Higher total testosterone/estradiol ratio was independently associated with an elevated risk for incident CVD, CHD, and HF events. After >12 years of follow-up, the multivariable-adjusted Hazard Ratios (95% CI) associated with 1 SD greater log-transformed total testosterone/estradiol ratio for incident CVD, CHD and HF events were 1.19 (1.02–1.40), 1.45 (1.19–1.78), 1.31 (1.01–1.70), respectively. Sex hormones levels after menopause are associated with women’s increased CVD risk later in life.
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DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
影响因子：
16.2
作者：
Haffner, SM;Moss, SE;Klein, R
通讯作者：
Klein, R
影响因子：
4.9
作者：
Schaffrath, Gotja;Kische, Hanna;Haring, Robin
通讯作者：
Haring, Robin
DOI：
10.1161/atvbaha.114.304821
发表时间：
2015-02-01
影响因子：
8.7
作者：
Benn, Marianne;Voss, Sidsel Skou;Nordestgaard, Borge G.
通讯作者：
Nordestgaard, Borge G.
DOI：
10.1097/gme.0b013e31829a64f9
发表时间：
2014-03
期刊：
Menopause (New York, N.Y.)
影响因子：
--
作者：
Shufelt CL;Merz CN;Prentice RL;Pettinger MB;Rossouw JE;Aroda VR;Kaunitz AM;Lakshminarayan K;Martin LW;Phillips LS;Manson JE
通讯作者：
Manson JE