Journal Article

Sex Hormones and Change in N-Terminal Pro-B-Type Natriuretic Peptide Levels: The Multi-Ethnic Study of Atherosclerosis

Sharma, Kavita, Heckbert, Susan R, Ouyang, Pamela, Ndumele, Chiadi E, Post, Wendy S, Lima, Joao A, Ying, Wendy, Shah, Sanjiv J, deFilippi, Christopher R, Vaidya, Dhananjay, Michos, Erin D, Budoff, Matthew J, Subramanya, Vinita, Zhao, Di

2018

Overview

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. To evaluate whether total testosterone (T), bioavailable T, free T, estradiol, dehydroepiandrosterone (DHEA), and SHBG are associated with NT-proBNP. Cohort study. Cross-sectional sample included 2371 postmenopausal women and 2688 men free of CVD, of which 2041 women and 2348 men were included longitudinally. NT-proBNP at baseline (2000 to 2002) and one or more repeat NT-proBNPs (through 2012). Analyses adjusted for CVD risk factors. 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). 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.

• Publisher: Copyright Oxford University Press,Oxford University Press,Endocrine Society
• Subject: 17β-Estradiol / Aged / Arteriosclerosis / Atherosclerosis / Atherosclerosis - blood / Bioavailability / Brain natriuretic peptide / Cardiovascular diseases / Clinical s / Cross-Sectional Studies / Dehydroepiandrosterone / Female / Gender differences / Gonadal Steroid Hormones - blood / Hormone replacement therapy / Humans / Longitudinal Studies / Male / Menopause / Middle Aged / Natriuretic Peptide, Brain - blood / Peptide Fragments - blood / Peptides / Post-menopause / Prospective Studies / Risk factors / Sex differences / Sex Factors / Sex hormones / Testosterone / Women