TY - JOUR
T1 - Sex hormones and incident heart failure in men and postmenopausal women
T2 - The atherosclerosis risk in communities study
AU - Zhao, Di
AU - Guallar, Eliseo
AU - Ballantyne, Christie M.
AU - Post, Wendy S.
AU - Ouyang, Pamela
AU - Vaidya, Dhananjay
AU - Jia, Xiaoming
AU - Ying, Wendy
AU - Subramanya, Vinita
AU - Ndumele, Chiadi E.
AU - Hoogeveen, Ron C.
AU - Michos, Erin D.
N1 - Publisher Copyright:
© Endocrine Society 2020. All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Context: Sex differences exist in heart failure (HF) phenotypes, but there is limited research on the role of sex hormones in HF and its subtypes. Objective: To examine the associations of total testosterone, dehydroepiandrosterone sulfate (DHEA-S), and sex hormone-binding globulin (SHBG) with incident HF, HF with preserved ejection fraction (HFpEF), and HF with reduced ejection fraction (HFrEF). Design: Atherosclerosis Risk in Communities (ARIC) study (prospective cohort study). Median follow-up is 19.2 years. Setting: General community. Participants: 4107 men and 4839 postmenopausal women, with mean age of 63.2 (standard deviation [SD] 5.7) and 62.8 (5.5) years, respectively. Exposure: Plasma sex hormone levels were measured at visit 4 (1996-1998). Main Outcome Measures: Incident HF events were identified through hospital discharge codes and death certificates. Results: The Hazard Ratios for HF associated with 1 SD decrease in log-transformed total testosterone, DHEA-S, and SHBG were 1.10 (95% confidence interval 1.03, 1.17), 1.07 (1.00, 1.15), and 1.04 (0.96, 1.11) in men, and 1.05 (0.99, 1.13), 1.17 (1.09, 1.24), and 0.93 (0.85, 1.01) in women, respectively. The associations between sex hormones with subtypes of HF had similar patterns but were attenuated and became statistically insignificant. Conclusion: In this prospective cohort, lower levels of endogenous testosterone and DHEA-S in men and DHEA-S in postmenopausal women were associated with the development of HF.play a role in the development of HF through common pathways regardless of sex.
AB - Context: Sex differences exist in heart failure (HF) phenotypes, but there is limited research on the role of sex hormones in HF and its subtypes. Objective: To examine the associations of total testosterone, dehydroepiandrosterone sulfate (DHEA-S), and sex hormone-binding globulin (SHBG) with incident HF, HF with preserved ejection fraction (HFpEF), and HF with reduced ejection fraction (HFrEF). Design: Atherosclerosis Risk in Communities (ARIC) study (prospective cohort study). Median follow-up is 19.2 years. Setting: General community. Participants: 4107 men and 4839 postmenopausal women, with mean age of 63.2 (standard deviation [SD] 5.7) and 62.8 (5.5) years, respectively. Exposure: Plasma sex hormone levels were measured at visit 4 (1996-1998). Main Outcome Measures: Incident HF events were identified through hospital discharge codes and death certificates. Results: The Hazard Ratios for HF associated with 1 SD decrease in log-transformed total testosterone, DHEA-S, and SHBG were 1.10 (95% confidence interval 1.03, 1.17), 1.07 (1.00, 1.15), and 1.04 (0.96, 1.11) in men, and 1.05 (0.99, 1.13), 1.17 (1.09, 1.24), and 0.93 (0.85, 1.01) in women, respectively. The associations between sex hormones with subtypes of HF had similar patterns but were attenuated and became statistically insignificant. Conclusion: In this prospective cohort, lower levels of endogenous testosterone and DHEA-S in men and DHEA-S in postmenopausal women were associated with the development of HF.play a role in the development of HF through common pathways regardless of sex.
KW - DHEA-S
KW - Heart failure
KW - HFpEF
KW - HFrEF
KW - Sex hormone
KW - SHBG
KW - Testosterone
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U2 - 10.1210/clinem/dgaa500
DO - 10.1210/clinem/dgaa500
M3 - Article
C2 - 32770207
AN - SCOPUS:85090173657
SN - 0021-972X
VL - 105
SP - 1
EP - 10
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 10
ER -