Association Between High FSH, Low Progesterone, and Idiopathic Pulmonary Arterial Hypertension in Women of Reproductive Age

Abstract Background While sex differences characterize susceptibility and severity of idiopathic pulmonary arterial hypertension (IPAH), our understanding of the relationship between levels of gonadotropins and sex hormones in fertile women and the disease is limited. We aimed to investigate whether gonadotropin and sex hormone levels in women of reproductive age were associated with risk and mortality of IPAH. Methods We did a matched case-control study. Cases were reproductive female patients with idiopathic pulmonary arterial hypertension admitted in Shanghai Pulmonary Hospital (Tongji University School of Medicine, Shanghai, China) during 2008–2014. Healthy controls were matched on age and body mass index. We also did a prospective cohort study to assess the effects of hormone levels on mortality in IPAH fertile female patients. Results One hundred sixty-four cases and 133 controls were included. After adjustment for age and body mass index, the odds ratios of having IPAH for follicle-stimulating hormone, testosterone, and progesterone as expressed on natural log scale were 1.51 (95% confidence interval: 1.06, 2.16), 0.42 (0.31–0.57), and 0.52 (0.43–0.63), respectively. In the cohort study with a median follow-up of 77 months, the hazard ratios for dying after adjustment for baseline characteristics and treatments among IPAH patients were 2.01 (95% confidence interval: 1.22–3.30) and 0.78 (95% confidence interval: 0.62–0.98) for follicle-stimulating hormone and progesterone in natural log scale, respectively. Conclusions In reproductive women with IPAH, high follicle-stimulating hormone and low progesterone tended to be associated with high risk of IPAH and mortality among patients.

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Prognostic Value of Follicle-Stimulating Hormone Levels in Predicting Survival in Men With Idiopathic Pulmonary Arterial Hypertension

American Journal of Men s Health ◽

10.1177/15579883211067084 ◽

2022 ◽

Vol 16 (1) ◽

pp. 155798832110670

Author(s):

Qian Wang ◽

Yuan-Yuan Sun ◽

Yu-Xia Huang ◽

Lan Wang ◽

Yu-Qing Miao ◽

...

Keyword(s):

Survival Rate ◽

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Cox Regression ◽

Follicle Stimulating Hormone ◽

Idiopathic Pulmonary Arterial Hypertension ◽

World Health ◽

Pulmonary Arterial ◽

Male Patients ◽

Stimulating Hormone

The objective of the study was to assess the association between changes in plasma follicle-stimulating hormone (FSH) and the potential effect on idiopathic pulmonary arterial hypertension (IPAH) in male patients. A total of 116 male patients with IPAH and 53 healthy controls were included from XX Hospital. Plasma FSH concentration was assessed in all participants. Receiver operating characteristic curves were used to assess the mortality risk. Kaplan–Meier curve and Cox regression analyses were used to predict the value of FSH on the survival rate of male IPAH patients. The plasma FSH concentration in the IPAH group was significantly higher than that in the control group ( p = .017). Nonsurvivors had significantly higher levels of FSH than survivors ( p < .0001). FSH levels were positively correlated with World Health Organization Functional Class, mean pulmonary artery pressure, and pulmonary vascular resistance (PVR; p = .023, p < .0001, and p < .0001, respectively) and negatively correlated with 6-min walk distance (6MWD) and cardiac output (CO; p = .004 and p = .010). Cox regression model analysis showed that the levels of FSH were also the independent factors of mortality in male IPAH patients ( p < .0001). The IPAH patients with higher FSH levels had higher PVR, lower 6MWD, CO, and a lower survival rate ( p = .042, p = .003, p = .029, and p < .0001, respectively). Therefore, we identified that increased FSH levels were associated with disease severity in male patients with IPAH and independently predicted risk of disease and poor survival rate.

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Survival advantages of excess body mass index in patients with idiopathic pulmonary arterial hypertension

Acta Cardiologica ◽

10.1080/ac.69.6.1000010 ◽

2014 ◽

Vol 69 (6) ◽

pp. 673-678 ◽

Cited By ~ 7

Author(s):

En-Ci Hu ◽

Jian-Guo He ◽

Zhi-Hong Liu ◽

Xin-Hai Ni ◽

Ya-Guo Zheng ◽

...

Keyword(s):

Body Mass Index ◽

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Body Mass ◽

Idiopathic Pulmonary Arterial Hypertension ◽

Pulmonary Arterial

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Nocturnal hypoxia in patients with idiopathic pulmonary arterial hypertension

Pulmonary Circulation ◽

10.1177/2045894019885364 ◽

2020 ◽

Vol 10 (3) ◽

pp. 204589401988536

Author(s):

Lu Yan ◽

Qin Luo ◽

Zhihui Zhao ◽

Qing Zhao ◽

Qi Jin ◽

...

Keyword(s):

Body Mass Index ◽

Logistic Regression ◽

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Oxygen Saturation ◽

Body Mass ◽

Sleep Disordered Breathing ◽

Idiopathic Pulmonary Arterial Hypertension ◽

Pulmonary Arterial ◽

Disordered Breathing

Background Sleep-disordered breathing causes a variety of cardiovascular complications and increases the risk of a poor prognosis in patients. There is still some controversy regarding the clinical diagnosis and treatment of sleep-disordered breathing in patients with pulmonary hypertension. The aim of this study was to determine the incidence of desaturation in idiopathic pulmonary arterial hypertension (IPAH) patients, evaluate the effect of desaturation on the clinical status of patients with IPAH, and identify possible influencing factors. Methods Patients with IPAH diagnosed by right heart catheterization who underwent overnight cardiorespiratory monitoring from January 2018 to July 2019 were enrolled. Nocturnal hypoxic time was defined as the time that oxygen saturation remained below 90%. Desaturation was defined as a nocturnal oxygen saturation level less than 90% for more than 10% of the total recording time. Baseline clinical characteristics and parameters were collected to compare IPAH patients with and without desaturation. In addition, logistic regression was performed to identify possible factors associated with desaturation in IPAH patients. Results Fifty patients with IPAH were included. Among them, 17 patients presented desaturation. Patients with desaturation were older, had a shorter six-min walking distance (6MWD), had a higher mean right atrial pressure, and had a lower daytime arterial oxygen partial pressure than patients without desaturation, and there were significant differences in the VE/VCO2 and VE/VCO2 slope ( P < 0.05). The multivariate logistic regression analysis indicated that the 6 MWD (OR = 0.971, 95% CI: 0.948–0.994, P = 0.013) and; VE/VCO2 slope (OR = 1.095, 95% CI: 1.010–1.307, P = 0.032) were independently associated with desaturation after adjusting for age, sex, and body mass index. Conclusion Nocturnal hypoxia is common in IPAH patients. Desaturation may aggravate the clinical situation of patients with IPAH. In IPAH patients, a poor exercise capacity (6 MWD) and the VE/VCO2 slope can predict desaturation after adjusting for age, sex, and body mass index.

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