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Association of sex hormones with incident 10-year cardiovascular disease and mortality in women

  • Author Footnotes
    1 Both authors contributed equally.
    Gotja Schaffrath
    Footnotes
    1 Both authors contributed equally.
    Affiliations
    Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
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  • Author Footnotes
    1 Both authors contributed equally.
    Hanna Kische
    Footnotes
    1 Both authors contributed equally.
    Affiliations
    Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
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  • Stefan Gross
    Affiliations
    DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany

    Department of Cardiology, University Medicine Greifswald, Germany
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  • Henri Wallaschofski
    Affiliations
    Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany

    DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
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  • Henry Völzke
    Affiliations
    DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany

    Institute for Community Medicine, University Medicine Greifswald, Germany
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  • Marcus Dörr
    Affiliations
    DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany

    Department of Cardiology, University Medicine Greifswald, Germany
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  • Matthias Nauck
    Affiliations
    Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany

    DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
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  • Brian G. Keevil
    Affiliations
    Department of Clinical Chemistry, University Hospital South Manchester, UK
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  • Georg Brabant
    Affiliations
    Department of Clinical Chemistry, University Hospital South Manchester, UK
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  • Robin Haring
    Correspondence
    Corresponding author.
    Affiliations
    Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany

    DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany

    European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
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  • Author Footnotes
    1 Both authors contributed equally.

      Highlights

      • Associations between sex hormones and incident 10-year cardiovascular disease and mortality were studied in a population-based sample of 2219 women with a mean age of 49 years at baseline.
      • Levels of sex hormones were measured using liquid chromatography-tandem mass spectrometry, which is more accurate than the immunoassay methods used in previous studies.
      • An inverse association between sex hormone binding globulin and cardiovascular disease was found at baseline, but no consistent associations were found between sex hormones and incident cardiovascular disease or mortality risk.

      Abstract

      Objectives

      The aims of this study were to ascertain whether women with high levels of serum total testosterone (TT) or low levels of sex hormone-binding globulin (SHBG) are more likely to develop cardiovascular disease (CVD), and to investigate potential associations between sex hormones and mortality (all-cause, as well as cause-specific) in the general population.

      Study design and main outcome measures

      Data on 2129 women with a mean age of 49.0 years were obtained from the population-based Study of Health in Pomerania over a median follow-up of 10.9 years. Associations of baseline levels of TT, SHBG, and rostenedione (ASD), and free testosterone (fT), and of the free androgen index (FAI), with follow-up CVD morbidity, as well as all-cause and CVD mortality, were analyzed using multivariable regression modeling.

      Results

      At baseline the prevalence rate of CVD was 17.8% (378 women) and the incidence of CVD over the follow-up was 50.9 per 1000 person-years. We detected an inverse association between SHBG and baseline CVD in age-adjusted models (relative risk per standard deviation increase: 0.83; 95% confidence interval: 0.74–0.93). We did not detect any significant associations between sex hormone concentrations and incident CVD in age- and multivariable-adjusted Poisson regression models. Furthermore, none of the sex hormones (TT, SHBG, ASD, fT, FAI) were associated with all-cause mortality.

      Conclusions

      This population-based cohort study did not yield any consistent associations between sex hormones in women and incident CVD or mortality risk.

      Keywords

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