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 - Funding Information:
Financial Support: The MESA study was supported by Contracts HHSN268201500003I, 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 Grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from the National Center for Advancing Translational Sciences. This research was also supported by Grant R01-HL127659 from the National Heart, Lung, and Blood Institute to S.R.H. W.Y. was funded by the American Heart Association Go Red for Women Strategically Focused Research Network Grant 16SFRN27870000. D.Z. and E.D.M. are additionally funded by the Blumenthal Scholars Award in Preventive Cardiology at Johns Hopkins University.
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 -
