Association Between Statin Use and Sex Hormone in the Multi-Ethnic Study of Atherosclerosis Cohort

Oludamilola W. Oluleye, Richard A. Kronmal, Aaron R. Folsom, Dhananjay M. Vaidya, Pamela Ouyang, Daniel A. Duprez, Adrian S. Dobs, Hirad Yarmohammadi, Suma H. Konety

Research output: Contribution to journalArticle

Abstract

PURPOSE: Based on the 2018 American College of Cardiology/American Heart Association cholesterol guidelines, the number of individuals eligible for statin therapy to reduce atherosclerotic cardiovascular disease risk has greatly expanded. Statins inhibit cholesterol biosynthesis, which can impair gonadal steroidogenesis. We evaluated the effect of statins on endogenous sex hormones in a large epidemiological study. METHODS: A total of 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants underwent the baseline examination. Of these, 6171 had measurements of serum sex hormones available: dehydroepiandrosterone (DHEA), SHBG, estradiol, and total and bioavailable testosterone. Multivariable linear regression models were used to assess the relationship of statin use with each sex hormone. RESULTS: A total of 345 women (17.4%) and 464 men (14.7%) were statin users (mean age, 67 years; 41% white, 29% black, 11% Chinese, and 19% Hispanic). Among the users vs nonusers of statins, the mean SHBG was 3.54 nmol/L (P < 0.01) lower in women and 3.37 nmol/L (P < 0.001) lower in men; the mean DHEA was 1.06 nmol/L (P < 0.05) lower in women and 0.70 nmol/L (P < 0.01) lower in men, after adjustment for potential confounders. With further propensity score adjustment, the mean DHEA and SHBG levels were 0.67 nmol/L (P < 0.05) and 3.49 nmol/L (P < 0.001) lower, respectively, for statin users vs nonusers. No statistically significant association was noted between estradiol, total testosterone, and bioavailable testosterone and statin use. CONCLUSION: Statin users have lower levels of SHBG and DHEA. This is especially relevant owing to the increasing use of statin therapy.

Original languageEnglish (US)
Pages (from-to)4600-4606
Number of pages7
JournalThe Journal of clinical endocrinology and metabolism
Volume104
Issue number10
DOIs
StatePublished - Oct 1 2019

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Gonadal Steroid Hormones
Atherosclerosis
Cohort Studies
Dehydroepiandrosterone
Testosterone
Estradiol
Linear Models
Cholesterol
Propensity Score
Biosynthesis
Hispanic Americans
Linear regression
Epidemiologic Studies
Cardiovascular Diseases
Association reactions
Guidelines

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Association Between Statin Use and Sex Hormone in the Multi-Ethnic Study of Atherosclerosis Cohort. / Oluleye, Oludamilola W.; Kronmal, Richard A.; Folsom, Aaron R.; Vaidya, Dhananjay M.; Ouyang, Pamela; Duprez, Daniel A.; Dobs, Adrian S.; Yarmohammadi, Hirad; Konety, Suma H.

In: The Journal of clinical endocrinology and metabolism, Vol. 104, No. 10, 01.10.2019, p. 4600-4606.

Research output: Contribution to journalArticle

Oluleye, Oludamilola W. ; Kronmal, Richard A. ; Folsom, Aaron R. ; Vaidya, Dhananjay M. ; Ouyang, Pamela ; Duprez, Daniel A. ; Dobs, Adrian S. ; Yarmohammadi, Hirad ; Konety, Suma H. / Association Between Statin Use and Sex Hormone in the Multi-Ethnic Study of Atherosclerosis Cohort. In: The Journal of clinical endocrinology and metabolism. 2019 ; Vol. 104, No. 10. pp. 4600-4606.
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abstract = "PURPOSE: Based on the 2018 American College of Cardiology/American Heart Association cholesterol guidelines, the number of individuals eligible for statin therapy to reduce atherosclerotic cardiovascular disease risk has greatly expanded. Statins inhibit cholesterol biosynthesis, which can impair gonadal steroidogenesis. We evaluated the effect of statins on endogenous sex hormones in a large epidemiological study. METHODS: A total of 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants underwent the baseline examination. Of these, 6171 had measurements of serum sex hormones available: dehydroepiandrosterone (DHEA), SHBG, estradiol, and total and bioavailable testosterone. Multivariable linear regression models were used to assess the relationship of statin use with each sex hormone. RESULTS: A total of 345 women (17.4{\%}) and 464 men (14.7{\%}) were statin users (mean age, 67 years; 41{\%} white, 29{\%} black, 11{\%} Chinese, and 19{\%} Hispanic). Among the users vs nonusers of statins, the mean SHBG was 3.54 nmol/L (P < 0.01) lower in women and 3.37 nmol/L (P < 0.001) lower in men; the mean DHEA was 1.06 nmol/L (P < 0.05) lower in women and 0.70 nmol/L (P < 0.01) lower in men, after adjustment for potential confounders. With further propensity score adjustment, the mean DHEA and SHBG levels were 0.67 nmol/L (P < 0.05) and 3.49 nmol/L (P < 0.001) lower, respectively, for statin users vs nonusers. No statistically significant association was noted between estradiol, total testosterone, and bioavailable testosterone and statin use. CONCLUSION: Statin users have lower levels of SHBG and DHEA. This is especially relevant owing to the increasing use of statin therapy.",
author = "Oluleye, {Oludamilola W.} and Kronmal, {Richard A.} and Folsom, {Aaron R.} and Vaidya, {Dhananjay M.} and Pamela Ouyang and Duprez, {Daniel A.} and Dobs, {Adrian S.} and Hirad Yarmohammadi and Konety, {Suma H.}",
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T1 - Association Between Statin Use and Sex Hormone in the Multi-Ethnic Study of Atherosclerosis Cohort

AU - Oluleye, Oludamilola W.

AU - Kronmal, Richard A.

AU - Folsom, Aaron R.

AU - Vaidya, Dhananjay M.

AU - Ouyang, Pamela

AU - Duprez, Daniel A.

AU - Dobs, Adrian S.

AU - Yarmohammadi, Hirad

AU - Konety, Suma H.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - PURPOSE: Based on the 2018 American College of Cardiology/American Heart Association cholesterol guidelines, the number of individuals eligible for statin therapy to reduce atherosclerotic cardiovascular disease risk has greatly expanded. Statins inhibit cholesterol biosynthesis, which can impair gonadal steroidogenesis. We evaluated the effect of statins on endogenous sex hormones in a large epidemiological study. METHODS: A total of 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants underwent the baseline examination. Of these, 6171 had measurements of serum sex hormones available: dehydroepiandrosterone (DHEA), SHBG, estradiol, and total and bioavailable testosterone. Multivariable linear regression models were used to assess the relationship of statin use with each sex hormone. RESULTS: A total of 345 women (17.4%) and 464 men (14.7%) were statin users (mean age, 67 years; 41% white, 29% black, 11% Chinese, and 19% Hispanic). Among the users vs nonusers of statins, the mean SHBG was 3.54 nmol/L (P < 0.01) lower in women and 3.37 nmol/L (P < 0.001) lower in men; the mean DHEA was 1.06 nmol/L (P < 0.05) lower in women and 0.70 nmol/L (P < 0.01) lower in men, after adjustment for potential confounders. With further propensity score adjustment, the mean DHEA and SHBG levels were 0.67 nmol/L (P < 0.05) and 3.49 nmol/L (P < 0.001) lower, respectively, for statin users vs nonusers. No statistically significant association was noted between estradiol, total testosterone, and bioavailable testosterone and statin use. CONCLUSION: Statin users have lower levels of SHBG and DHEA. This is especially relevant owing to the increasing use of statin therapy.

AB - PURPOSE: Based on the 2018 American College of Cardiology/American Heart Association cholesterol guidelines, the number of individuals eligible for statin therapy to reduce atherosclerotic cardiovascular disease risk has greatly expanded. Statins inhibit cholesterol biosynthesis, which can impair gonadal steroidogenesis. We evaluated the effect of statins on endogenous sex hormones in a large epidemiological study. METHODS: A total of 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants underwent the baseline examination. Of these, 6171 had measurements of serum sex hormones available: dehydroepiandrosterone (DHEA), SHBG, estradiol, and total and bioavailable testosterone. Multivariable linear regression models were used to assess the relationship of statin use with each sex hormone. RESULTS: A total of 345 women (17.4%) and 464 men (14.7%) were statin users (mean age, 67 years; 41% white, 29% black, 11% Chinese, and 19% Hispanic). Among the users vs nonusers of statins, the mean SHBG was 3.54 nmol/L (P < 0.01) lower in women and 3.37 nmol/L (P < 0.001) lower in men; the mean DHEA was 1.06 nmol/L (P < 0.05) lower in women and 0.70 nmol/L (P < 0.01) lower in men, after adjustment for potential confounders. With further propensity score adjustment, the mean DHEA and SHBG levels were 0.67 nmol/L (P < 0.05) and 3.49 nmol/L (P < 0.001) lower, respectively, for statin users vs nonusers. No statistically significant association was noted between estradiol, total testosterone, and bioavailable testosterone and statin use. CONCLUSION: Statin users have lower levels of SHBG and DHEA. This is especially relevant owing to the increasing use of statin therapy.

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