Sex hormone-binding globulin and the free androgen index are related to cardiovascular risk factors in multiethnic premenopausal and perimenopausal women enrolled in the study of women across the nation (SWAN)

被引:303
作者
Sutton-Tyrrell, K
Wildman, RP
Matthews, KA
Chae, C
Lasley, BL
Brockwell, S
Pasternak, RC
Lloyd-Jones, D
Sowers, MF
Torréns, JI
机构
[1] Univ Pittsburgh, Dept Epidemiol, Grad Sch Publ Hlth, Pittsburgh, PA 15261 USA
[2] Tulane Univ, Sch Publ Hlth & Trop Med, Dept Epidemiol, New Orleans, LA USA
[3] Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA
[4] Massachusetts Gen Hosp, Div Cardiol, Boston, MA 02114 USA
[5] Brigham & Womens Hosp, Div Prevent Med, Boston, MA 02115 USA
[6] Univ Calif Davis, Dept Populat Hlth & Reprod, Davis, CA 95616 USA
[7] Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA
[8] Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA
[9] Univ Med & Dent New Jersey, Dept Obstet Gynecol & Womens Hlth, Newark, NJ USA
关键词
hormones; aging; sex; menopause; risk factors;
D O I
10.1161/01.CIR.0000157697.54255.CE
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background - Recent clinical trials have shifted attention away from estrogens and toward androgens and sex hormone - binding globulin (SHBG) as potential mediators of increasing cardiovascular (CV) risk in women at midlife. Methods and Results - The correlation between reproductive hormones and CV risk factors was evaluated in a multiethnic (white, black, Hispanic, Chinese, and Japanese) sample of 3297 premenopausal and perimenopausal women. Testosterone and estradiol (E-2) were evaluated along with SHBG and the free androgen index (FAI), the amount of testosterone not bound by SHBG. Low SHBG and high FAI were strongly and consistently related to elevated CV risk factors (higher insulin, glucose, and hemostatic and inflammatory markers and adverse lipids) even after controlling for body mass index (P < 0.001 for all). Low levels of E-2 were associated with elevated CV risk factors to a lesser degree. These observations were consistent across the 5 ethnic groups. Compared with whites, blacks had higher levels of SHBG and lower levels of FAI, and Chinese had lower levels of SHBG and higher levels of FAI. Conclusions - Low SHBG and high FAI are strongly associated with CV risk factors in racially diverse women, and thus, androgens likely play a role in the CV risk profile of perimenopausal women.
引用
收藏
页码:1242 / 1249
页数:8
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