Sex hormone levels and change in left ventricular structure among men and post-menopausal women: The Multi-Ethnic Study of Atherosclerosis (MESA)

Vinita Subramanya, Di Zhao, Pamela Ouyang, Joao A. Lima, Dhananjay Vaidya, Chiadi E. Ndumele, David A. Bluemke, Sanjiv J. Shah, Eliseo Guallar, Chike C. Nwabuo, Matthew A. Allison, Susan R. Heckbert, Wendy S. Post, Erin D. Michos

Research output: Contribution to journalArticle

Abstract

Objective Sex hormone (SH) levels may contribute to sex differences in the risk of heart failure with preserved ejection fraction (HFpEF). We examined the associations of SH levels with left ventricular mass (LVM) and mass (M):volume (V) ratio, which are risk markers for HFpEF. Study design We studied 1941 post-menopausal women and 2221 men, aged 45–84 years, participating in the Multi-Ethnic Study of Atherosclerosis (MESA). Serum SH levels, cardiac magnetic resonance imaging (MRI) and ejection fraction (EF) ≥50% had been recorded at baseline (2000–2002). Of these participants, 2810 underwent repeat MRI at Exam 5 (2010–2012). Stratified by sex, linear mixed-effect models were used to test associations between SH and sex hormone binding globulin (SHBG) level [per 1 SD greater log-transformed (SH)] with baseline and change in LV structure. Models were adjusted for age, race/ethnicity, center, height, weight, education, physical activity and smoking, and, in women, for hormone therapy and years since menopause. Main outcome measures LVM and M:V ratio. Results After a median of 9.1 years, higher free testosterone levels were independently associated with a modest increase in LVM (g/yr) in women [0.05 (95% CI 0.01, 0.10)] and men [0.16 (0.03, 0.28)], while higher SHBG levels were associated with less LVM change (g/yr) in women [−0.07 (−0.13, −0.01)] and men [−0.15 (−0.27, −0.02)]. In men, higher dehydroepiandrosterone and estradiol levels were associated with increased LVM. Among women, free testosterone levels were positively and SHBG levels inversely associated with change in M:V ratio. Conclusion A more androgenic profile (higher free testosterone and lower SHBG levels) is associated with a greater increase in LVM in men and women and greater increase in M:V ratio in women over the course of 9 years.

LanguageEnglish (US)
Pages37-44
Number of pages8
JournalMaturitas
Volume108
DOIs
StatePublished - Feb 1 2018

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Gonadal Steroid Hormones
Sex Hormone-Binding Globulin
Atherosclerosis
Testosterone
Magnetic resonance
Imaging techniques
Dehydroepiandrosterone
Heart Failure
Magnetic Resonance Imaging
Estradiol
Education
Menopause
Hormones
Sex Characteristics
Smoking
Odds Ratio
Outcome Assessment (Health Care)
Exercise
Weights and Measures
Serum

Keywords

  • Cardiac magnetic resonance imaging
  • Epidemiology
  • Left ventricular remodeling
  • Sex differences
  • Sex hormones

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Obstetrics and Gynecology

Cite this

Sex hormone levels and change in left ventricular structure among men and post-menopausal women : The Multi-Ethnic Study of Atherosclerosis (MESA). / Subramanya, Vinita; Zhao, Di; Ouyang, Pamela; Lima, Joao A.; Vaidya, Dhananjay; Ndumele, Chiadi E.; Bluemke, David A.; Shah, Sanjiv J.; Guallar, Eliseo; Nwabuo, Chike C.; Allison, Matthew A.; Heckbert, Susan R.; Post, Wendy S.; Michos, Erin D.

In: Maturitas, Vol. 108, 01.02.2018, p. 37-44.

Research output: Contribution to journalArticle

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abstract = "Objective Sex hormone (SH) levels may contribute to sex differences in the risk of heart failure with preserved ejection fraction (HFpEF). We examined the associations of SH levels with left ventricular mass (LVM) and mass (M):volume (V) ratio, which are risk markers for HFpEF. Study design We studied 1941 post-menopausal women and 2221 men, aged 45–84 years, participating in the Multi-Ethnic Study of Atherosclerosis (MESA). Serum SH levels, cardiac magnetic resonance imaging (MRI) and ejection fraction (EF) ≥50{\%} had been recorded at baseline (2000–2002). Of these participants, 2810 underwent repeat MRI at Exam 5 (2010–2012). Stratified by sex, linear mixed-effect models were used to test associations between SH and sex hormone binding globulin (SHBG) level [per 1 SD greater log-transformed (SH)] with baseline and change in LV structure. Models were adjusted for age, race/ethnicity, center, height, weight, education, physical activity and smoking, and, in women, for hormone therapy and years since menopause. Main outcome measures LVM and M:V ratio. Results After a median of 9.1 years, higher free testosterone levels were independently associated with a modest increase in LVM (g/yr) in women [0.05 (95{\%} CI 0.01, 0.10)] and men [0.16 (0.03, 0.28)], while higher SHBG levels were associated with less LVM change (g/yr) in women [−0.07 (−0.13, −0.01)] and men [−0.15 (−0.27, −0.02)]. In men, higher dehydroepiandrosterone and estradiol levels were associated with increased LVM. Among women, free testosterone levels were positively and SHBG levels inversely associated with change in M:V ratio. Conclusion A more androgenic profile (higher free testosterone and lower SHBG levels) is associated with a greater increase in LVM in men and women and greater increase in M:V ratio in women over the course of 9 years.",
keywords = "Cardiac magnetic resonance imaging, Epidemiology, Left ventricular remodeling, Sex differences, Sex hormones",
author = "Vinita Subramanya and Di Zhao and Pamela Ouyang and Lima, {Joao A.} and Dhananjay Vaidya and Ndumele, {Chiadi E.} and Bluemke, {David A.} and Shah, {Sanjiv J.} and Eliseo Guallar and Nwabuo, {Chike C.} and Allison, {Matthew A.} and Heckbert, {Susan R.} and Post, {Wendy S.} and Michos, {Erin D.}",
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T2 - Maturitas

AU - Subramanya,Vinita

AU - Zhao,Di

AU - Ouyang,Pamela

AU - Lima,Joao A.

AU - Vaidya,Dhananjay

AU - Ndumele,Chiadi E.

AU - Bluemke,David A.

AU - Shah,Sanjiv J.

AU - Guallar,Eliseo

AU - Nwabuo,Chike C.

AU - Allison,Matthew A.

AU - Heckbert,Susan R.

AU - Post,Wendy S.

AU - Michos,Erin D.

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N2 - Objective Sex hormone (SH) levels may contribute to sex differences in the risk of heart failure with preserved ejection fraction (HFpEF). We examined the associations of SH levels with left ventricular mass (LVM) and mass (M):volume (V) ratio, which are risk markers for HFpEF. Study design We studied 1941 post-menopausal women and 2221 men, aged 45–84 years, participating in the Multi-Ethnic Study of Atherosclerosis (MESA). Serum SH levels, cardiac magnetic resonance imaging (MRI) and ejection fraction (EF) ≥50% had been recorded at baseline (2000–2002). Of these participants, 2810 underwent repeat MRI at Exam 5 (2010–2012). Stratified by sex, linear mixed-effect models were used to test associations between SH and sex hormone binding globulin (SHBG) level [per 1 SD greater log-transformed (SH)] with baseline and change in LV structure. Models were adjusted for age, race/ethnicity, center, height, weight, education, physical activity and smoking, and, in women, for hormone therapy and years since menopause. Main outcome measures LVM and M:V ratio. Results After a median of 9.1 years, higher free testosterone levels were independently associated with a modest increase in LVM (g/yr) in women [0.05 (95% CI 0.01, 0.10)] and men [0.16 (0.03, 0.28)], while higher SHBG levels were associated with less LVM change (g/yr) in women [−0.07 (−0.13, −0.01)] and men [−0.15 (−0.27, −0.02)]. In men, higher dehydroepiandrosterone and estradiol levels were associated with increased LVM. Among women, free testosterone levels were positively and SHBG levels inversely associated with change in M:V ratio. Conclusion A more androgenic profile (higher free testosterone and lower SHBG levels) is associated with a greater increase in LVM in men and women and greater increase in M:V ratio in women over the course of 9 years.

AB - Objective Sex hormone (SH) levels may contribute to sex differences in the risk of heart failure with preserved ejection fraction (HFpEF). We examined the associations of SH levels with left ventricular mass (LVM) and mass (M):volume (V) ratio, which are risk markers for HFpEF. Study design We studied 1941 post-menopausal women and 2221 men, aged 45–84 years, participating in the Multi-Ethnic Study of Atherosclerosis (MESA). Serum SH levels, cardiac magnetic resonance imaging (MRI) and ejection fraction (EF) ≥50% had been recorded at baseline (2000–2002). Of these participants, 2810 underwent repeat MRI at Exam 5 (2010–2012). Stratified by sex, linear mixed-effect models were used to test associations between SH and sex hormone binding globulin (SHBG) level [per 1 SD greater log-transformed (SH)] with baseline and change in LV structure. Models were adjusted for age, race/ethnicity, center, height, weight, education, physical activity and smoking, and, in women, for hormone therapy and years since menopause. Main outcome measures LVM and M:V ratio. Results After a median of 9.1 years, higher free testosterone levels were independently associated with a modest increase in LVM (g/yr) in women [0.05 (95% CI 0.01, 0.10)] and men [0.16 (0.03, 0.28)], while higher SHBG levels were associated with less LVM change (g/yr) in women [−0.07 (−0.13, −0.01)] and men [−0.15 (−0.27, −0.02)]. In men, higher dehydroepiandrosterone and estradiol levels were associated with increased LVM. Among women, free testosterone levels were positively and SHBG levels inversely associated with change in M:V ratio. Conclusion A more androgenic profile (higher free testosterone and lower SHBG levels) is associated with a greater increase in LVM in men and women and greater increase in M:V ratio in women over the course of 9 years.

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