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)

Kim Sutton-Tyrrell*, Rachel P. Wildman, Karen A. Matthews, Claudia Chae, Bill L. Lasley, Sarah Brockwell, Richard C. Pasternak, Donald Lloyd-Jones, Mary Fran Sowers, Javier I. Torréns

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

272 Scopus citations

Abstract

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 (E2) 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 E2 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.

Original languageEnglish (US)
Pages (from-to)1242-1249
Number of pages8
JournalCirculation
Volume111
Issue number10
DOIs
StatePublished - Mar 15 2005

Keywords

  • Aging
  • Hormones
  • Menopause
  • Risk factors
  • Sex

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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