Cardiometabolic Risk Factors and Endogenous Sex Hormones in Postmenopausal Women: A Cross-Sectional Study

Kristin Ottarsdottir; Åsa Tivesten; Ying Li; Ulf Lindblad; Margareta Hellgren; Claes Ohlsson; Bledar Daka

doi:10.1210/jendso/bvac050

Cardiometabolic Risk Factors and Endogenous Sex Hormones in Postmenopausal Women: A Cross-Sectional Study

J Endocr Soc. 2022 Apr 1;6(6):bvac050. doi: 10.1210/jendso/bvac050. eCollection 2022 Jun 1.

Authors

Kristin Ottarsdottir^{1

2}, Åsa Tivesten^{3

4}, Ying Li⁵, Ulf Lindblad¹, Margareta Hellgren¹, Claes Ohlsson^{6

7}, Bledar Daka¹

Affiliations

¹ General Practice-Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
² The Local Research and Development Council Södra Älvsborg, 503 38 Borås, Sweden.
³ Wallenberg Laboratory for Cardiovascular and Metabolic Research, Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 413 45 Gothenburg, Sweden.
⁴ Department of Endocrinology, Sahlgrenska University Hospital, Region Västra Götaland, 413 45 Gothenburg, Sweden.
⁵ Biostatistics, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
⁶ Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
⁷ Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, 413 45 Gothenburg, Sweden.

Abstract

Context: It is uncertain which cardiovascular risk factors are associated with sex hormone levels in postmenopausal women.

Objective: This work aimed to investigate the association between cardiometabolic risk factors and sex hormones in a cross-sectional, observational population study.

Methods: In this Swedish population study, participants were physically examined from 2002 to 2004, and endogenous sex hormones were analyzed by liquid chromatography-tandem mass spectrometry. Women aged 55 years or older with estradiol levels below 20 pg/mL and not using any hormonal therapy were eligible for inclusion in the study (N = 146). Variable selection and bootstrap stability analyses were performed and linear regression models presented, with each of the 8 hormones as outcome variables.

Results: Body mass index (BMI) was positively associated with estradiol (β = 0.054, P < .001), but negatively associated with 17-α-hydroxyprogesterone (β = -0.023, P = .028). Waist-to-hip ratio (WHR) was negatively associated with dihydrotestosterone (β = -2.195, P = .002) and testosterone (β = -1.541, P = .004). The homeostatic model assessment of insulin resistance was positively associated with androstenedione (β = 0.071, P = .032), estradiol (β = 0.091, P = .009), estrone (β = 0.075, P = 0.009), and 17-α-hydroxyprogesterone (β = 0.157, P = .001). Age was positively associated with testosterone (β = 0.017, P = .042). C-reactive protein showed an inverse association with progesterone (β = -0.028, P = .037). Lower low-density lipoprotein cholesterol was associated with higher estradiol levels (β = -0.093, P = .049), whereas lower triglycerides were associated with higher concentrations of dihydrotestosterone (β = -0.208, P = .016).

Conclusion: In postmenopausal women, WHR was strongly inversely associated with androgens, while BMI was positively associated with estrogens.

Keywords: body composition; chromatography mass spectrometry gas liquid; menopause; postmenopausal period; sex steroid hormones.