Abstract
The objective of this work was to evaluate the associations between levels of endogenous sex hormones in women at midlife and lipoprotein subclasses. One hundred and twenty women (68 late peri-/postmenopausal and 52 pre-/early perimenopausal) from the Study of Women's Health Across the Nation (Pittsburgh site) were included. Lipoprotein subclasses were quantified using NMR spectroscopy. Participants (57.5% White and 42.5% Black) were 50.4 ± 1.9 years old. Adjusting for age, race, cycle day of blood draw, BMI, physical activity, and alcohol consumption, a negative correlation was found between estradiol (E2) and medium-small LDL particle (LDL-P) concentration (ρ = -0.19, P = 0.04). Further, E2 was positively correlated with HDL particle (HDL-P) size (ρ = 0.22, P = 0.02). For sex hormone binding globulin (SHBG), independent negative correlation was found with total small LDL-P concentration. SHBG was also positively correlated with LDL-P and HDL-P sizes (P < 0.05 for all). For free androgen index (FAI), positive correlations were found with concentrations of total VLDL particles, total LDL-Ps, and total small LDL-Ps. Additionally, FAI was negatively correlated with large HDL-P concentration, and HDL-P and LDL-P sizes (P < 0.05 for all). Lower levels of E2 and SHBG, and higher levels of FAI were associated with a more atherogenic profile of lipoprotein subclasses. Sex hormone levels at midlife may increase women's risk of coronary heart disease.
Highlights
The objective of this work was to evaluate the associations between levels of endogenous sex hormones in women at midlife and lipoprotein subclasses
We found that lower levels of E2 and sex hormone binding globulin (SHBG) and higher levels of free androgen index (FAI) were independently associated with smaller/denser LDL particle (LDL-P) and smaller LDL-P and/or HDL particle (HDL-P) sizes in women at midlife
Higher levels of FAI were associated with higher total VLDL particle (VLDL-P) concentration
Summary
The objective of this work was to evaluate the associations between levels of endogenous sex hormones in women at midlife and lipoprotein subclasses. As women age, they are increasingly exposed to greater levels of CVD risk factors, including a poor lipid/lipoprotein profile [1,2,3]. In lipoprotein profile around the time of menopause, including increases in total cholesterol, triglycerides, ApoB, and LDL cholesterol (LDL-C) [1, 4,5,6,7], which suggest a possible role of endogenous sex hormones. The reduction in plasma estradiol (E2) level that accompanies the menopausal transition has been suggested as a possible mechanism for this alteration of lipid profiles This hypothesis was supported by the favorable influence of hormone therapy (HT) on lipids/lipoproteins [8, 9]. High concentrations of small LDL particles (LDL-Ps) and small HDL particles (HDL-Ps) [12, 13], and total VLDL particles (VLDL-Ps) and large VLDL-Ps [13, 14] have been found to be associated with greater risk of CVD, while larger LDLand HDL-P sizes are significantly associated with reduced incidence of CVD [14]
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