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Relationship of Endogenous Sex Hormones to Coronary Heart Disease: A Twin Study

Department of Medicine (K.H.M., R.M.), Stanford University School of Medicine, Stanford, California 94305; The Geriatrics Research, Education & Clinical Center (L.H., R.M.), Palo Alto Veterans Affairs Medical Center, Palo Alto, California 94304; Center for Health Sciences (R.E.K., H.J., G.E.S., D.C.), SRI International, Menlo Park, California 94025; and Department of Medical and Molecular Genetics (T.R.), Indiana University School of Medicine, Indianapolis, Indiana 46202

Address all correspondence and requests for reprints to: Katharine H. Mikulec, M.D., Brigham and Women’s Hospital, Division of Endocrinology, Diabetes, and Hypertension, 221 Longwood Avenue, Boston, Massachusetts 02115. E-mail: kmikulec{at}partners.org.

We examined the association between endogenous sex hormones (estradiol, estrone, testosterone, and SHBG) and coronary heart disease (CHD) in white male twins. Stored plasma samples were available for 566 participants of the National Heart, Lung, and Blood Institute Twin Study, a longitudinal study of cardiovascular disease in male twins. Twenty-eight of these individuals were lost to follow-up, and outcome data were missing. Of the remaining 538 participants, 78 had CHD at baseline, and 154 subsequently developed CHD over 20 yr of follow-up. We observed no differences in mean unadjusted or age- and body mass index-adjusted log-transformed sex hormone concentrations for participants with and without CHD (all P > 0.08). Quartile and median split analyses revealed no significant association between any of the sex hormones and either prevalent or incident CHD. The discordant monozygotic twins showed no significant case-control group difference in estradiol, estrone, testosterone, and SHBG (all P > 0.3). The positive and negative concordant twin pairs had similar values for each of the sex hormones (all P > 0.3). We observed no relationship between endogenous sex hormone concentrations and prevalent or incident CHD in this sample of male twins.

Supported in part by the National Heart, Lung, and Blood Institute Grant R01-HL51429 and by the Department of Veteran Affairs.

Current address for K.H.M.: Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts 02115.

Current address for R.M.: Eli Lilly & Company, Indianapolis, Indiana 46285.

Abbreviations: BMI, Body mass index; CHD, coronary heart disease; DZ, dizygotic; HDL, high-density lipoprotein; ICD-9, International Classification of Diseases, Ninth Revision; MI, myocardial infarction; MZ, monozygotic; SBP, systolic blood pressure.

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