Endogenous Sex Hormones and Endothelial Function in Postmenopausal Women and Men: The Multi-Ethnic Study of Atherosclerosis

Lena Mathews, Vinita Subramanya, Di Zhao, Pamela Ouyang, Dhananjay Vaidya, Eliseo Guallar, Joseph Yeboah, David Herrington, Allison Hays, Matthew J. Budoff, Erin Donnelly Michos

Research output: Contribution to journalArticle

Abstract

Background: The relationship of endogenous sex hormones (SH) with vascular endothelial function and with cardiovascular disease (CVD) is incompletely understood. We examined the associations between SH and endothelial function measured by brachial artery flow-mediated dilation (FMD). Materials and Methods: We included 1368 postmenopausal women and 1707 men, free of clinical CVD, participating in MESA Visit 1 (2000-2002). Serum SH [total testosterone, SH binding globulin (SHBG), dehydroepiandrosterone (DHEA), estradiol] were measured; free testosterone was calculated. The percent FMD difference (%FMD) was measured by high-resolution ultrasound. Using multivariable-adjusted linear regression, we tested the cross-sectional associations of SH (log transformed, compared per one SD increment) with %FMD. Results: The mean age of women and men were 64.2 and 61.4 years, respectively. Among women, after adjusting for demographics, CVD risk factors, and hormone therapy, higher SHBG was associated with greater %FMD [β = 0.215% (95% CI 0.026-0.405)], whereas higher free testosterone was associated with a smaller %FMD [-0.209% (-0.402, -0.017)]. Estradiol and DHEA were not associated with %FMD in women after multivariable adjustment. There was an age interaction, with higher free testosterone and lower SHBG associated with worse FMD in women <65 years of age, but not in those ≥65 years (p = 0.04). We did not see similar associations in men. Conclusions: A more androgenic SH profile of higher free testosterone and lower SHBG was associated with worse %FMD in postmenopausal women. Changes in SH with aging and menopause may result in vascular changes in women. Further studies are needed to assess longitudinal changes in SH levels and their association with vascular function.

Original languageEnglish (US)
Pages (from-to)900-909
Number of pages10
JournalJournal of women's health (2002)
Volume28
Issue number7
DOIs
StatePublished - Jul 1 2019

Fingerprint

Gonadal Steroid Hormones
Dilatation
Atherosclerosis
Testosterone
Globulins
Blood Vessels
Cardiovascular Diseases
Dehydroepiandrosterone
Estradiol
Sex Hormone-Binding Globulin
Brachial Artery
Menopause
Linear Models
Demography
Hormones
Serum

Keywords

  • cardiovascular disease
  • endothelial function
  • menopause
  • sex hormones

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{23cc5b7ac4b54f6bb662b9b72c7f170c,
title = "Endogenous Sex Hormones and Endothelial Function in Postmenopausal Women and Men: The Multi-Ethnic Study of Atherosclerosis",
abstract = "Background: The relationship of endogenous sex hormones (SH) with vascular endothelial function and with cardiovascular disease (CVD) is incompletely understood. We examined the associations between SH and endothelial function measured by brachial artery flow-mediated dilation (FMD). Materials and Methods: We included 1368 postmenopausal women and 1707 men, free of clinical CVD, participating in MESA Visit 1 (2000-2002). Serum SH [total testosterone, SH binding globulin (SHBG), dehydroepiandrosterone (DHEA), estradiol] were measured; free testosterone was calculated. The percent FMD difference ({\%}FMD) was measured by high-resolution ultrasound. Using multivariable-adjusted linear regression, we tested the cross-sectional associations of SH (log transformed, compared per one SD increment) with {\%}FMD. Results: The mean age of women and men were 64.2 and 61.4 years, respectively. Among women, after adjusting for demographics, CVD risk factors, and hormone therapy, higher SHBG was associated with greater {\%}FMD [β = 0.215{\%} (95{\%} CI 0.026-0.405)], whereas higher free testosterone was associated with a smaller {\%}FMD [-0.209{\%} (-0.402, -0.017)]. Estradiol and DHEA were not associated with {\%}FMD in women after multivariable adjustment. There was an age interaction, with higher free testosterone and lower SHBG associated with worse FMD in women <65 years of age, but not in those ≥65 years (p = 0.04). We did not see similar associations in men. Conclusions: A more androgenic SH profile of higher free testosterone and lower SHBG was associated with worse {\%}FMD in postmenopausal women. Changes in SH with aging and menopause may result in vascular changes in women. Further studies are needed to assess longitudinal changes in SH levels and their association with vascular function.",
keywords = "cardiovascular disease, endothelial function, menopause, sex hormones",
author = "Lena Mathews and Vinita Subramanya and Di Zhao and Pamela Ouyang and Dhananjay Vaidya and Eliseo Guallar and Joseph Yeboah and David Herrington and Allison Hays and Budoff, {Matthew J.} and Michos, {Erin Donnelly}",
year = "2019",
month = "7",
day = "1",
doi = "10.1089/jwh.2018.7441",
language = "English (US)",
volume = "28",
pages = "900--909",
journal = "Journal of Women's Health",
issn = "1540-9996",
publisher = "Mary Ann Liebert Inc.",
number = "7",

}

TY - JOUR

T1 - Endogenous Sex Hormones and Endothelial Function in Postmenopausal Women and Men

T2 - The Multi-Ethnic Study of Atherosclerosis

AU - Mathews, Lena

AU - Subramanya, Vinita

AU - Zhao, Di

AU - Ouyang, Pamela

AU - Vaidya, Dhananjay

AU - Guallar, Eliseo

AU - Yeboah, Joseph

AU - Herrington, David

AU - Hays, Allison

AU - Budoff, Matthew J.

AU - Michos, Erin Donnelly

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Background: The relationship of endogenous sex hormones (SH) with vascular endothelial function and with cardiovascular disease (CVD) is incompletely understood. We examined the associations between SH and endothelial function measured by brachial artery flow-mediated dilation (FMD). Materials and Methods: We included 1368 postmenopausal women and 1707 men, free of clinical CVD, participating in MESA Visit 1 (2000-2002). Serum SH [total testosterone, SH binding globulin (SHBG), dehydroepiandrosterone (DHEA), estradiol] were measured; free testosterone was calculated. The percent FMD difference (%FMD) was measured by high-resolution ultrasound. Using multivariable-adjusted linear regression, we tested the cross-sectional associations of SH (log transformed, compared per one SD increment) with %FMD. Results: The mean age of women and men were 64.2 and 61.4 years, respectively. Among women, after adjusting for demographics, CVD risk factors, and hormone therapy, higher SHBG was associated with greater %FMD [β = 0.215% (95% CI 0.026-0.405)], whereas higher free testosterone was associated with a smaller %FMD [-0.209% (-0.402, -0.017)]. Estradiol and DHEA were not associated with %FMD in women after multivariable adjustment. There was an age interaction, with higher free testosterone and lower SHBG associated with worse FMD in women <65 years of age, but not in those ≥65 years (p = 0.04). We did not see similar associations in men. Conclusions: A more androgenic SH profile of higher free testosterone and lower SHBG was associated with worse %FMD in postmenopausal women. Changes in SH with aging and menopause may result in vascular changes in women. Further studies are needed to assess longitudinal changes in SH levels and their association with vascular function.

AB - Background: The relationship of endogenous sex hormones (SH) with vascular endothelial function and with cardiovascular disease (CVD) is incompletely understood. We examined the associations between SH and endothelial function measured by brachial artery flow-mediated dilation (FMD). Materials and Methods: We included 1368 postmenopausal women and 1707 men, free of clinical CVD, participating in MESA Visit 1 (2000-2002). Serum SH [total testosterone, SH binding globulin (SHBG), dehydroepiandrosterone (DHEA), estradiol] were measured; free testosterone was calculated. The percent FMD difference (%FMD) was measured by high-resolution ultrasound. Using multivariable-adjusted linear regression, we tested the cross-sectional associations of SH (log transformed, compared per one SD increment) with %FMD. Results: The mean age of women and men were 64.2 and 61.4 years, respectively. Among women, after adjusting for demographics, CVD risk factors, and hormone therapy, higher SHBG was associated with greater %FMD [β = 0.215% (95% CI 0.026-0.405)], whereas higher free testosterone was associated with a smaller %FMD [-0.209% (-0.402, -0.017)]. Estradiol and DHEA were not associated with %FMD in women after multivariable adjustment. There was an age interaction, with higher free testosterone and lower SHBG associated with worse FMD in women <65 years of age, but not in those ≥65 years (p = 0.04). We did not see similar associations in men. Conclusions: A more androgenic SH profile of higher free testosterone and lower SHBG was associated with worse %FMD in postmenopausal women. Changes in SH with aging and menopause may result in vascular changes in women. Further studies are needed to assess longitudinal changes in SH levels and their association with vascular function.

KW - cardiovascular disease

KW - endothelial function

KW - menopause

KW - sex hormones

UR - http://www.scopus.com/inward/record.url?scp=85070182456&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070182456&partnerID=8YFLogxK

U2 - 10.1089/jwh.2018.7441

DO - 10.1089/jwh.2018.7441

M3 - Article

C2 - 31170017

AN - SCOPUS:85070182456

VL - 28

SP - 900

EP - 909

JO - Journal of Women's Health

JF - Journal of Women's Health

SN - 1540-9996

IS - 7

ER -