TY - JOUR
T1 - Sex hormone levels and change in left ventricular structure among men and post-menopausal women
T2 - The Multi-Ethnic Study of Atherosclerosis (MESA)
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.
N1 - Funding Information:
The authors report no conflicts of interest related to the topic of the paper. Dr. Michos has received an honorarium from Siemens Diagnostics unrelated to the topic of the paper. Dr. Ouyang has research grant support from Cordex Systems, Inc.
Funding Information:
Dr. Subramanya’s postdoctoral fellowship is funded by the American Heart Association Go Red for Women Strategic Focused Research Network contract AHA 16SFRN27870000. Drs. Michos and Zhao were supported by the Blumenthal Scholars Fund for Preventive Cardiology Research . Dr. Shah is supported by NIH/NHLBI grants R01 HL107577 and R01 HL127028 , and by AHA grant #16SFRN28780016 . The MESA study was supported by contracts N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, and N01-HC-95169 from the National Heart, Lung, and Blood Institute, and by R01 HL074406 and R01 HL074338.
PY - 2018/2
Y1 - 2018/2
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.
KW - Cardiac magnetic resonance imaging
KW - Epidemiology
KW - Left ventricular remodeling
KW - Sex differences
KW - Sex hormones
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U2 - 10.1016/j.maturitas.2017.11.006
DO - 10.1016/j.maturitas.2017.11.006
M3 - Article
C2 - 29290213
AN - SCOPUS:85034029337
VL - 108
SP - 37
EP - 44
JO - Maturitas
JF - Maturitas
SN - 0378-5122
ER -