TY - JOUR
T1 - Sex hormones and change in N-terminal pro–B-type natriuretic peptide levels
T2 - The multi-ethnic study of atherosclerosis
AU - Ying, Wendy
AU - Zhao, Di
AU - Ouyang, Pamela
AU - Subramanya, Vinita
AU - Vaidya, Dhananjay
AU - Ndumele, Chiadi E.
AU - Sharma, Kavita
AU - Shah, Sanjiv J.
AU - Heckbert, Susan R.
AU - Lima, Joao A.
AU - deFilippi, Christopher R.
AU - Budoff, Matthew J.
AU - Post, Wendy S.
AU - Michos, Erin D.
N1 - Publisher Copyright:
Copyright © 2018 Endocrine Society.
PY - 2018
Y1 - 2018
N2 - Context: Sex hormones may influence sex differences in cardiovascular disease (CVD). N-terminal pro–B-type natriuretic peptide (NT-proBNP), a predictor of CVD, is higher in women than men, which may relate to sex hormones. Objective: To evaluate whether total testosterone (T), bioavailable T, free T, estradiol, dehydroepiandrosterone (DHEA), and SHBG are associated with NT-proBNP. Design: Cohort study. Participants: Cross-sectional sample included 2371 postmenopausal women and 2688 men free of CVD, of which 2041 women and 2348 men were included longitudinally. Main Outcome Measures: NT-proBNP at baseline (2000 to 2002) and one or more repeat NT-proBNPs (through 2012). Analyses adjusted for CVD risk factors. Results: Women had higher NT-proBNP than men (median 79.9 vs 38.5 pg/mL). Cross-sectionally, higher bioavailable T, free T, DHEA, and lower SHBG levels were independently associated with lower NT-proBNP among both women and men (all P, 0.05). Higher total T in women and estradiol in men were also associated with lower NT-proBNP (both P, 0.05). Longitudinally, in women, higher total T, bioavailable T, free T, DHEA, and lower estradiol and SHBG were associated with greater 10-year increase in NT-proBNP (all P, 0.05). In men, higher free T and estradiol were associated with greater NT-proBNP increase (both P, 0.05). Conclusions: A more androgenic sex hormone pattern was inversely associated with NT-proBNP cross-sectionally and may contribute to sex differences in NT-proBNP. Longitudinally, a more androgenic sex hormone pattern was associated with greater increase in NT-proBNP in women, which may reflect a mechanism for CVD risk after menopause.
AB - Context: Sex hormones may influence sex differences in cardiovascular disease (CVD). N-terminal pro–B-type natriuretic peptide (NT-proBNP), a predictor of CVD, is higher in women than men, which may relate to sex hormones. Objective: To evaluate whether total testosterone (T), bioavailable T, free T, estradiol, dehydroepiandrosterone (DHEA), and SHBG are associated with NT-proBNP. Design: Cohort study. Participants: Cross-sectional sample included 2371 postmenopausal women and 2688 men free of CVD, of which 2041 women and 2348 men were included longitudinally. Main Outcome Measures: NT-proBNP at baseline (2000 to 2002) and one or more repeat NT-proBNPs (through 2012). Analyses adjusted for CVD risk factors. Results: Women had higher NT-proBNP than men (median 79.9 vs 38.5 pg/mL). Cross-sectionally, higher bioavailable T, free T, DHEA, and lower SHBG levels were independently associated with lower NT-proBNP among both women and men (all P, 0.05). Higher total T in women and estradiol in men were also associated with lower NT-proBNP (both P, 0.05). Longitudinally, in women, higher total T, bioavailable T, free T, DHEA, and lower estradiol and SHBG were associated with greater 10-year increase in NT-proBNP (all P, 0.05). In men, higher free T and estradiol were associated with greater NT-proBNP increase (both P, 0.05). Conclusions: A more androgenic sex hormone pattern was inversely associated with NT-proBNP cross-sectionally and may contribute to sex differences in NT-proBNP. Longitudinally, a more androgenic sex hormone pattern was associated with greater increase in NT-proBNP in women, which may reflect a mechanism for CVD risk after menopause.
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U2 - 10.1210/jc.2018-01437
DO - 10.1210/jc.2018-01437
M3 - Article
C2 - 30137406
AN - SCOPUS:85054345635
SN - 0021-972X
VL - 103
SP - 4304
EP - 4314
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 11
ER -