TY - JOUR
T1 - Neighborhood walkability and sex steroid hormone levels in women
AU - India-Aldana, Sandra
AU - Rundle, Andrew G.
AU - Clendenen, Tess V.
AU - Quinn, James W.
AU - Arslan, Alan A.
AU - Afanasyeva, Yelena
AU - Koenig, Karen L.
AU - Liu, Mengling
AU - Neckerman, Kathryn M.
AU - Thorpe, Lorna E.
AU - Zeleniuch-Jacquotte, Anne
AU - Chen, Yu
N1 - Publisher Copyright:
© 2022
PY - 2022/12
Y1 - 2022/12
N2 - Background: Neighborhood walkability (NW) has been linked to increased physical activity, which in turn is associated with lower concentrations of sex hormones and higher concentration of SHBG in women. However, no study has directly examined the association of NW with female sex hormone levels. Objective: We conducted a cross-sectional study to evaluate the association between NW and circulating levels of sex hormones and SHBG in pre- and post-menopausal women. Methods: We included 797 premenopausal and 618 postmenopausal women from the New York University Women's Health Study (NYUWHS) who were healthy controls in previous nested case-control studies in which sex hormones (androstenedione, testosterone, DHEAS, estradiol and estrone) and SHBG had been measured in serum at enrollment. Baseline residential addresses were geo-coded and the Built Environment and Health Neighborhood Walkability Index (BEH-NWI) was calculated. Generalized Estimating Equations were used to assess the association between BEH-NWI and sex hormone and SHBG concentrations adjusting for individual- and neighborhood-level factors. Results: In premenopausal women, a one standard deviation (SD) increment in BEH-NWI was associated with a 3.5% (95% CI 0.9%–6.1%) lower DHEAS concentration. In postmenopausal women, a one SD increment in BEH-NWI was related to an 8.5% (95% CI 5.4%–11.5%) lower level of DHEAS, a 3.7% (95% CI 0.5%–6.8%) lower level of testosterone, a 1.8% (95% CI 0.5%–3.0%) lower level of estrone, and a 4.2% (95% CI 2.7%–5.7%) higher level of SHBG. However, the associations with respect to DHEAS and estrone became apparent only after adjusting for neighborhood-level variables. Sensitivity analyses using fixed effects meta-analysis and inverse probability weighting accounting for potential selection bias yielded similar results. Conclusion: Our findings suggest that NW is associated with lower concentrations of androgens and estrone, and increased SHBG, in postmenopausal women, and lower levels of DHEAS in premenopausal women.
AB - Background: Neighborhood walkability (NW) has been linked to increased physical activity, which in turn is associated with lower concentrations of sex hormones and higher concentration of SHBG in women. However, no study has directly examined the association of NW with female sex hormone levels. Objective: We conducted a cross-sectional study to evaluate the association between NW and circulating levels of sex hormones and SHBG in pre- and post-menopausal women. Methods: We included 797 premenopausal and 618 postmenopausal women from the New York University Women's Health Study (NYUWHS) who were healthy controls in previous nested case-control studies in which sex hormones (androstenedione, testosterone, DHEAS, estradiol and estrone) and SHBG had been measured in serum at enrollment. Baseline residential addresses were geo-coded and the Built Environment and Health Neighborhood Walkability Index (BEH-NWI) was calculated. Generalized Estimating Equations were used to assess the association between BEH-NWI and sex hormone and SHBG concentrations adjusting for individual- and neighborhood-level factors. Results: In premenopausal women, a one standard deviation (SD) increment in BEH-NWI was associated with a 3.5% (95% CI 0.9%–6.1%) lower DHEAS concentration. In postmenopausal women, a one SD increment in BEH-NWI was related to an 8.5% (95% CI 5.4%–11.5%) lower level of DHEAS, a 3.7% (95% CI 0.5%–6.8%) lower level of testosterone, a 1.8% (95% CI 0.5%–3.0%) lower level of estrone, and a 4.2% (95% CI 2.7%–5.7%) higher level of SHBG. However, the associations with respect to DHEAS and estrone became apparent only after adjusting for neighborhood-level variables. Sensitivity analyses using fixed effects meta-analysis and inverse probability weighting accounting for potential selection bias yielded similar results. Conclusion: Our findings suggest that NW is associated with lower concentrations of androgens and estrone, and increased SHBG, in postmenopausal women, and lower levels of DHEAS in premenopausal women.
KW - Neighborhood walkability
KW - Sex steroid hormones
KW - Urban health
KW - Women's health
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U2 - 10.1016/j.envres.2022.114285
DO - 10.1016/j.envres.2022.114285
M3 - Article
C2 - 36088991
AN - SCOPUS:85137819015
SN - 0013-9351
VL - 215
JO - Environmental Research
JF - Environmental Research
M1 - 114285
ER -