scholarly journals Sex Hormones and Incident Heart Failure in Men and Postmenopausal Women: The Atherosclerosis Risk in Communities Study

2020 ◽  
Vol 105 (10) ◽  
pp. e3798-e3807 ◽  
Author(s):  
Di Zhao ◽  
Eliseo Guallar ◽  
Christie M Ballantyne ◽  
Wendy S Post ◽  
Pamela Ouyang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Postmenopausal Women ◽  
Sex Hormones ◽  
Prospective Cohort ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk

Abstract Context Sex differences exist in heart failure (HF) phenotypes, but there is limited research on the role of sex hormones in HF and its subtypes. Objective To examine the associations of total testosterone, dehydroepiandrosterone sulfate (DHEA-S), and sex hormone-binding globulin (SHBG) with incident HF, HF with preserved ejection fraction (HFpEF), and HF with reduced ejection fraction (HFrEF). Design Atherosclerosis Risk in Communities (ARIC) study (prospective cohort study). Median follow-up is 19.2 years. Setting General community. Participants 4107 men and 4839 postmenopausal women, with mean age of 63.2 (standard deviation [SD] 5.7) and 62.8 (5.5) years, respectively. Exposure Plasma sex hormone levels were measured at visit 4 (1996-1998). Main Outcome Measures Incident HF events were identified through hospital discharge codes and death certificates. Results The Hazard Ratios for HF associated with 1 SD decrease in log-transformed total testosterone, DHEA-S, and SHBG were 1.10 (95% confidence interval 1.03, 1.17), 1.07 (1.00, 1.15), and 1.04 (0.96, 1.11) in men, and 1.05 (0.99, 1.13), 1.17 (1.09, 1.24), and 0.93 (0.85, 1.01) in women, respectively. The associations between sex hormones with subtypes of HF had similar patterns but were attenuated and became statistically insignificant. Conclusion In this prospective cohort, lower levels of endogenous testosterone and DHEA-S in men and DHEA-S in postmenopausal women were associated with the development of HF. Similar directions of association in both sexes and both HF subtypes suggest that sex hormones play a role in the development of HF through common pathways regardless of sex.

Abstract P012: Association Between Testosterone And Sex Hormone Binding Globulin And Risk Of Ischemic Stroke: The Atherosclerosis Risk In Communities Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Carin A Northuis ◽  
Erin Michos ◽  
Christie M Ballantyne ◽  
Ron C Hoogeveen ◽  
Pamela L Lutsey ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Sex Hormones ◽  
Stroke Risk ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Hormone Binding ◽  
Atherosclerosis Risk In Communities ◽  
Menopausal Women ◽  
Atherosclerosis Risk ◽  
Post Menopausal

Background: Sex hormones are associated with obesity, diabetes mellitus, and other stroke risk factors; however, studies on sex hormones and stroke risk report inconsistent results. We assessed the associations of testosterone and sex hormone binding globulin (SHBG) with risk of ischemic stroke among men and post-menopausal women in the Atherosclerosis Risk in Communities (ARIC) Study. Methods: A total of 4,349 men and 4,720 post-menopausal women who had SHBG and total testosterone measurements at visit 4 (1996-98) were followed through 2018 for the development of ischemic stroke. We examined log transformed SHBG and testosterone exposure as quartiles and as per 1 SD increment. We used Cox regression to estimate the hazard ratios (HR) for ischemic stroke, adjusting for demographic, behavioral and clinical variables. Analyses were stratified by sex and menopausal hormone therapy (HT) use. Results: Participants were aged 63±6 years at baseline, 52% were women (25% HT users), and 21% Black. There were 691 strokes over a median follow-up of 19.8 years. Mean log SHBG (nmol/L) and testosterone (nmol/L) were 4.3±0.7 and 3.1±0.5 for HT users, 3.6±0.7 and 3.2±0.5 for non-HT users, and 3.4±0.5 and 6.2±0.5 for men. Quartile 1 vs Q4 for SHBG and testosterone were ≤50.3 vs >121 and ≤16 vs >28 in HT users, ≤23.3 vs >55 and ≤17.9 vs >32.7 in non-HT users, and ≤23.3 vs >41.8 and ≤388 vs >657 in men. SHBG and testosterone were not significantly associated with stroke in any group (Figure). The HRs [95% confidence interval] for highest to lowest SHBG and testosterone quartiles were 1.04 [0.51-2.14] and 1.64 [0.85-3.17] in HT-users, 1.02 [0.70-1.48] and 1.16 [0.83-1.62] in HT non-users, and 0.96 [0.70-1.32] and 0.87 [0.63-1.21] in men, respectively. The HRs for stroke associated with 1 SD increase in SHBG and testosterone were 1.14 [0.88-1.46] and 1.19 [0.96-1.46] in HT users. Associations were also null among non-HT users and men. Conclusion: SHBG and testosterone were not associated with ischemic stroke risk in this cohort of older men and post-menopausal women.

scholarly journals Association of sex hormones and sex hormone–binding globulin with depressive symptoms in postmenopausal women

2012 ◽  
Vol 19 (8) ◽  
pp. 877-885 ◽  
Author(s):  
Laura A. Colangelo ◽  
Lynette L. Craft ◽  
Pamela Ouyang ◽  
Kiang Liu ◽  
Pamela J. Schreiner ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Postmenopausal Women ◽  
Sex Hormones ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Hormone Binding

Abstract MP34: The Association Between Periodontal Disease And Incident Heart Failure: The Atherosclerosis Risk In Communities Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Rebecca L Molinsky ◽  
Faye L Norby ◽  
Bing Yu ◽  
Amil M Shah ◽  
Pamela L Lutsey ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Periodontal Disease ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Atherosclerosis Risk In Communities ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Incident Heart Failure

Introduction: Periodontal disease, resulting from inflammatory host-response to dysbiotic subgingival microbiota, has been associated with incident hypertension, heart attack, stroke and diabetes. Limited data exist investigating the prospective relationship between periodontal disease and incident heart failure (HF) and HF subtypes. We hypothesize that periodontal disease is associated with increased risk for heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF). Methods: We studied 6,707 participants enrolled in the Atherosclerosis Risk in Communities Study who received a full-mouth clinical periodontal examination at visit 4 (1996-1998) and had longitudinal follow-up starting in 2005. Participants were classified as being periodontally healthy, having periodontal disease (based on the Periodontal Profile Classification (PPC)), or being edentulous. Hospitalization records were reviewed, and HF events were adjudicated and classified as HFpEF, HFrEF or HF of unknown ejection fraction (HFunknownEF) from 2005-2018. We used multivariable-adjusted Cox proportional hazards models to assess the association between periodontal disease or edentulism and incident HF. Results: Among participants 58% had periodontitis and 19% were edentulous. During a median follow-up time of 13 years, 1,178 cases of incident HF occurred (350 HFpEF, 319 HFrEF and 509 HFunknownEF). Periodontal disease and being edentulous were both associated with increased risk for both HFpEF and HFrEF (Table). Conclusion: Periodontal disease measured in mid-life was associated with both incident HFpEF and HFrEF. Adverse microbial exposures underlying periodontal disease might represent a modifiable risk factor for inflammation-induced heart failure pathophysiology.

Urinary Equol is Associated with Bioavailable Testosterone but not Total Testosterone in Women

2019 ◽  
Author(s):  
Hong-li Dong ◽  
Feng Xiong ◽  
Qing-wei Zhong ◽  
Yi-hong Li ◽  
Meng Liu ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Menopausal Status ◽  
Premenopausal Women ◽  
Positive Association ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Significant Positive Association ◽  
Cross Sectional ◽  
Bioavailable Testosterone

Little is known about the association between equol and bioavailable testosterone (BT) in adults. We examined the associations of urinary equol concentrations with serum total, bioavailable and free testosterone (FT), dehydroepiandrosterone sulfide (DHEAS), free androgen index (FAI) and sex hormone-binding globulin (SHBG) concentrations. This cross-sectional study included 1904 women aged 59.7 years. Urinary equol and serum sex hormone concentrations were measured. Overall, urinary equol tended to be inversely associated with bioactive forms of androgenic indices (BT, FT or FAI) but not with total testosterone (TT) or DHEAS. Urinary equol was also positively associated with SHBG. In multi-covariate-adjusted analyses stratified by menopausal status, graded and inverse associations between urinary equol and bioactive forms of androgenic indices (BT, FT and FAI) were observed in postmenopausal women (all p-trends <0.05), but not in premenopausal women. A significant positive association between urinary equol and SHBG was observed only in postmenopausal women. No significant associations were observed between urinary equol and TT or DHEAS in either group. A path analysis indicated that these associations of equol with androgens in postmenopausal women might be mediated by SHBG. Our findings indicated urinary equol exhibited graded and inverse associations with BT or FT but not TT in women.

scholarly journals Sex Hormone–Binding Globulin and Risk of Clinical Diabetes in American Black, Hispanic, and Asian/Pacific Islander Postmenopausal Women

2012 ◽  
Vol 58 (10) ◽  
pp. 1457-1466 ◽  
Author(s):  
Brian H Chen ◽  
Kathleen Brennan ◽  
Atsushi Goto ◽  
Yiqing Song ◽  
Najib Aziz ◽  
...  
Keyword(s):  
Postmenopausal Women ◽  
Diabetes Risk ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Clinical Diabetes ◽  
Total Testosterone ◽  
Inverse Association ◽  
Hormone Binding ◽  
Strong Inverse Association ◽  
Asian Pacific

Abstract BACKGROUND Recent prospective studies have shown a strong inverse association between sex hormone–binding globulin (SHBG) concentrations and risk of clinical diabetes in white individuals. However, it remains unclear whether this relationship extends to other racial/ethnic populations. METHODS We evaluated the association between baseline concentrations of SHBG and clinical diabetes risk in the Women's Health Initiative Observational Study. Over a median follow-up of 5.9 years, we identified 642 postmenopausal women who developed clinical diabetes (380 blacks, 157 Hispanics, 105 Asians) and 1286 matched controls (777 blacks, 307 Hispanics, 202 Asians). RESULTS Higher concentrations of SHBG at baseline were associated with a significantly lower risk of clinical diabetes [relative risk (RR), 0.15; 95% CI, 0.09–0.26 for highest vs lowest quartile of SHBG, adjusted for BMI and known diabetes risk factors]. The associations remained consistent within ethnic groups [RR, 0.19 (95% CI, 0.10–0.38) for blacks; RR, 0.17 (95% CI, 0.05–0.57) for Hispanics; and 0.13 (95% CI, 0.03–0.48) for Asians]. Adjustment for potential confounders, such as total testosterone (RR, 0.11; 95% CI, 0.07–0.19) or HOMA-IR (RR, 0.26; 95% CI, 0.14–0.48) did not alter the RR substantially. In addition, SHBG concentrations were significantly associated with risk of clinical diabetes across categories of hormone therapy use (never users: RRper SD = 0.42, 95% CI, 0.34–0.51; past users: RRper SD = 0.53;, 95% CI, 0.37–0.77; current users: RRper SD = 0.57; 95% CI, 0.46–0.69; P-interaction = 0.10). CONCLUSIONS In this prospective study of postmenopausal women, we observed a robust, inverse relationship between serum concentrations of SHBG and risk of clinical diabetes in American blacks, Hispanics, and Asians/Pacific Islanders. These associations appeared to be independent of sex hormone concentrations, adiposity, or insulin resistance.

scholarly journals Associations Between Dietary Inflammatory Index and Sex Hormones Among 6- to 19-Year-Old Children and Adolescents in NHANES 2015–2016

2022 ◽  
Vol 12 ◽  
Author(s):  
Yuxia Ma ◽  
Ruiqiang Li ◽  
Wenqiang Zhan ◽  
Xin Huang ◽  
Yutian Zhou ◽  
...  
Keyword(s):  
Steroid Hormones ◽  
Sex Hormones ◽  
Linear Regression Analysis ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Female Adolescents ◽  
Total Testosterone ◽  
Dietary Inflammatory Index ◽  
Negatively Associated ◽  
Inflammatory Index

ObjectivesThis study aimed to assess the relationship between dietary inflammatory index (DII) and sex steroids in children (6-11 years old) and adolescents (12-19 years old) in the U.S. National Health and Nutrition Examination Survey, 2015–2016.MethodsParticipants between the ages of 6-19 have 24-hour dietary intake data, serum sex hormones [total testosterone (TT), estradiol (E2)], and sex hormone-binding globulin (SHBG) available data (n = 1382). The free androgen index (FAI) is calculated as TT divided by SHBG and the ratio of TT to E2 (TT/E2). The constructed puberty state is defined as high levels of steroid hormones (TT≥50 ng/dL in men, E2≥20 pg/ml in women) or onset of menarche. Multiple linear regression analysis was stratified by gender-age and gender-pubertal status groups to evaluate the association between DII and sex hormone levels.ResultsAfter adjusting for covariates, the association between consecutive DII and sex hormone indicators by gender and age group. In male adolescents, DII was always negatively associated with TT (P-trend = 0.09), FAI (P-trend = 0.03) and E2 (P-trend = 0.01), and monotonically positively associated with SHBG (P-trend = 0.02).In female adolescents, with the increase of DII, a significant positive correlation with SHBG was observed (β 0.017, 95%CI: 0.009,0.053) (Table 3). Among female adolescents, a significant negative association between DII and TT and a significant positive association between SHBG were observed in this group. Moreover, DII was positively associated with SHBG of prepubertal males and negatively associated with FAI of prepubertal females.ConclusionsDII was associated with decreased levels of certain sex steroid hormones (TT, FAI, and E2) and increased levels of SHBG in adolescents or pubertal individuals, with the associations presenting somewhat sex-dependent pattern. However, there is little evidence that there is a significant association in children or prepubertal children. Further research needs to be carried out to verify our results.

Abstract P054: Endogenous Sex Hormone Levels and Endothelial Function Among Men and Post-Menopausal Women in the Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Lena Mathews ◽  
Vinita Subramanya ◽  
Di Zhao ◽  
Pamela Ouyang ◽  
Dhanajay Vaidya ◽  
...  
Keyword(s):  
Endothelial Function ◽  
Sex Hormones ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Total Testosterone ◽  
Cvd Risk ◽  
Men And Women ◽  
Hormone Levels ◽  
Menopausal Women ◽  
Post Menopausal

Background: Sex is a major determinant of cardiovascular disease (CVD). Endogenous sex hormones exert a variety of effects on the vascular endothelium, and changes in sex hormone levels after menopause may play a role in CVD risk in women. We hypothesized that a more androgenic sex hormone profile among post-menopausal women, but not among men, would be associated with reduced blood flow-mediated vasodilation (FMD) of the brachial artery, a marker of worse endothelial function. Methods: We examined 1396 post-menopausal women and 1707 men participating in MESA, who were free of clinical CVD at baseline. Sex hormone levels [total testosterone (T), sex hormone binding globulin (SHBG), estradiol (E2)] were measured at Exam 1 (2000-02); free T and T/E2 ratio were calculated. FMD was measured by high-resolution ultrasound. Using multivariable adjusted Poisson and linear regression methods, we tested the cross-sectional associations of sex hormones (log transformed) with FMD. Results: The mean age of men and women was 61 and 64 years, respectively. Of women, 34% were using hormone therapy (HT). Among women, after adjusting for demographics, CVD risk factors, and HT use, higher SHBG was associated with higher FMD, whereas higher free T was associated with lower FMD (Table, Model 2). In women, when examining the “best FMD response” (top decile vs. bottom 9 deciles), higher E2 was positively associated with a prevalent best response, whereas higher free T was inversely associated. Among men, a higher T/E2 ratio was marginally associated with lower FMD. Conclusion: The association between sex hormones and FMD differs in men and women. Higher E2 and SHBG and lower free T levels were associated with better FMD in post-menopausal women but not in men. Higher T/E2 ratio was associated with lower FMD in men. Further studies are needed to assess longitudinal changes in sex hormone levels and their association with vascular aging. Sex hormone levels may help identify individuals at increased CVD risk who may benefit from other risk reduction strategies.

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