Sex steroid hormones and subclinical atherosclerosis progression in postmenopausal women.

IF 5.2 1区医学 Q1 ENDOCRINOLOGY & METABOLISM European Journal of Endocrinology Pub Date : 2025-03-03 DOI:10.1093/ejendo/lvaf032

Irene J Chen, Frank Z Stanczyk, Intira Sriprasert, Roksana Karim, Donna Shoupe, Naoko Kono, Howard N Hodis, Wendy J Mack

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Abstract

Objective: The Early versus Late Intervention Trial with Estradiol demonstrated that hormone therapy (HT) reduces subclinical atherosclerosis progression in healthy postmenopausal women who initiated HT in proximity to menopause (<6 years) but not in those distant from menopause (≥10 years). This analysis explores the role of serum sex steroid hormones and sex hormone-binding globulin (SHBG) in atherosclerosis progression, examining differences based on time since menopause.

Design: Post-trial analysis.

Methods: The study included 535 healthy postmenopausal women; nearly half received HT. Serum levels of estradiol, estrone, testosterone, and SHBG were measured at baseline, 12 months, and 36 months. Carotid artery intima-media thickness (CIMT) was assessed every 6 months. Mixed-effects linear models evaluated the relationship between sex steroid hormones, SHBG, and CIMT progression, with time since menopause included as an interaction term, adjusting for age, hysterectomy, baseline CIMT, systolic blood pressure, and body mass index.

Results: Late postmenopausal women were older with higher baseline CIMT. Associations between estradiol, estrone, and SHBG levels with CIMT progression differed significantly by time since menopause (interaction P < .01). In early postmenopause, CIMT progression was significantly inversely associated with SHBG (P = .024) and nonsignificantly inversely with estradiol and estrone. In late postmenopause, CIMT progression was significantly positively associated with estradiol (P = .005), estrone (P < .001), and SHBG (P = .037).

Conclusions: Serum sex steroid hormones and SHBG relate differently to CIMT progression based on time since menopause. Estradiol, estrone, and SHBG levels show opposite associations with CIMT progression in early versus late postmenopause, highlighting the importance of HT timing in cardiovascular disease.

Clinical trial registration number: ClinicalTrials.gov, NCT00114517.

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绝经后妇女体内的性类固醇激素与亚临床动脉粥样硬化的进展。

目的：雌二醇早期与晚期干预试验表明，激素治疗（HT）可减少临近绝经的健康绝经后妇女的亚临床动脉粥样硬化进展（设计：试验后分析）。方法：纳入535名健康绝经后妇女；近一半接受了HT治疗。在基线、12个月和36个月时测定血清雌二醇、雌酮、睾酮和SHBG水平。每6个月评估一次颈动脉内膜-中膜厚度（CIMT）。混合效应线性模型评估性类固醇激素、SHBG和CIMT进展之间的关系，包括绝经后的时间作为相互作用项，在调整年龄、子宫切除术、基线CIMT、收缩压和体重指数后。结果：晚期绝经妇女年龄较大，基线CIMT较高。绝经后不同时间，雌二醇、雌酮和SHBG水平与CIMT进展的关系存在显著差异（相互作用p ）。结论：绝经后不同时间，血清性类固醇激素和SHBG与CIMT进展的关系不同。雌二醇、雌酮和SHBG水平在绝经后早期和晚期与CIMT进展显示相反的相关性，突出了激素治疗时机在心血管疾病中的重要性。

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来源期刊

European Journal of Endocrinology 医学-内分泌学与代谢

CiteScore

9.80

自引率

3.40%

发文量

354

审稿时长

1 months

期刊介绍： European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica. The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology. Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials. Equal consideration is given to all manuscripts in English from any country.