TY - JOUR
T1 - Relations between endogenous androgens and estrogens in postmenopausal women with suspected ischemic heart disease
AU - Braunstein, Glenn D.
AU - Johnson, B. Delia
AU - Stanczyk, Frank Z.
AU - Bittner, Vera
AU - Berga, Sarah L.
AU - Shaw, Leslee
AU - Hodgson, T. Keta
AU - Paul-Labrador, Maura
AU - Azziz, Ricardo
AU - Merz, C. Noel Bairey
N1 - Funding Information:
This work was supported by Contracts N01-HV-68161, N01-HV-68162, N01-HV-68163, and N01-HV-68164 and Grants U01644829, U01 HL649141, and U01 HL649241 from the National Heart, Lung, and Blood Institutes; a General Clinical Research Center Grant M01-RR00425 from the National Center for Research Resources; and grants from the Gustavus and Luis Pfeiffer Research Foundation (Denville, NJ), The Women's Guild of Cedars-Sinai Medical Center (Los Angeles, CA), The Ladies Hospital Aid Society of Western Pennsylvania (Pittsburgh, PA), QMED, Inc. (Laurence Harbor, NJ), and The Edythe L. Broad Endowment, Cedars-Sinai Medical Center (Los Angeles, CA).
PY - 2008/11
Y1 - 2008/11
N2 - Context: Because androgens are obligatory precursors of estrogens, it is reasonable to assume that their serum concentrations would exhibit positive correlations. If so, then epidemiologic studies that examine the association between androgens and pathological processes should adjust the results for the independent effect of estrogens. Objective: The objective of the study was to examine the interrelationships among testosterone (T), and rostenedione, estradiol (E2), estrone, and SHBG in postmenopausal women. Design: This was a cross-sectional study of women participating in the National Heart, Blood, and Lung Institute-sponsored Women's Ischemia Syndrome Evaluation study. Setting: The study was conducted at four academic medical centers. Patients: A total of 284 postmenopausal women with chest pain symptoms or suspected myocardial ischemia. Main Outcome Measures: Post hoc analysis of the relationships among sex steroid hormones with insulin resistance, body mass index (BMI), and presence or absence of coronary artery disease as determined by coronary angiography. Results: BMI was significantly associated with insulin resistance, total E2, free E2, bioavailable E2, and free T. Highly significant correlations were found for total T, free T, and androstenedione with total E2, free E2, bioavailable E2, and estrone and persisted after adjustment for BMI and insulin resistance. A significant relationship was present between total and free T and the presence of coronary artery disease after adjustment for the effect of E2. Conclusions: Serum levels of androgens and estrogens track closely in postmenopausal women referred for coronary angiography for suspected myocardial ischemia. Epidemiological studies that relate sex steroid hormones to physiological or pathological processes need to control for the independent effect of both estrogens and androgens.
AB - Context: Because androgens are obligatory precursors of estrogens, it is reasonable to assume that their serum concentrations would exhibit positive correlations. If so, then epidemiologic studies that examine the association between androgens and pathological processes should adjust the results for the independent effect of estrogens. Objective: The objective of the study was to examine the interrelationships among testosterone (T), and rostenedione, estradiol (E2), estrone, and SHBG in postmenopausal women. Design: This was a cross-sectional study of women participating in the National Heart, Blood, and Lung Institute-sponsored Women's Ischemia Syndrome Evaluation study. Setting: The study was conducted at four academic medical centers. Patients: A total of 284 postmenopausal women with chest pain symptoms or suspected myocardial ischemia. Main Outcome Measures: Post hoc analysis of the relationships among sex steroid hormones with insulin resistance, body mass index (BMI), and presence or absence of coronary artery disease as determined by coronary angiography. Results: BMI was significantly associated with insulin resistance, total E2, free E2, bioavailable E2, and free T. Highly significant correlations were found for total T, free T, and androstenedione with total E2, free E2, bioavailable E2, and estrone and persisted after adjustment for BMI and insulin resistance. A significant relationship was present between total and free T and the presence of coronary artery disease after adjustment for the effect of E2. Conclusions: Serum levels of androgens and estrogens track closely in postmenopausal women referred for coronary angiography for suspected myocardial ischemia. Epidemiological studies that relate sex steroid hormones to physiological or pathological processes need to control for the independent effect of both estrogens and androgens.
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U2 - 10.1210/jc.2008-0792
DO - 10.1210/jc.2008-0792
M3 - Article
C2 - 18728170
AN - SCOPUS:57349132097
SN - 0021-972X
VL - 93
SP - 4268
EP - 4275
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 11
ER -
