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Submitted on April 26, 2004
Accepted on November 8, 2004
Department of Medicine, Johns Hopkins University School of Medicineand the Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Department of Medicine, Wake Forest University Medical Center, Winston-Salem, NC; Department of Medicine, University of Pittsburgh School of Public Health, Pittsburgh, PA
* To whom correspondence should be addressed.
Sherita Hill Golden, E-mail: sahill{at}jhmi.edu
Previous studies have revealed that exogenous estrogen has a beneficial effect on the lipid profile; however, studies examining the relation between endogenous hormones and lipid profiles in post-menopausal women have yielded conflicting results. We sought to characterize the cross-sectional relationship between endogenous hormones and lipid parameters in post-menopausal women with significant (cases, n = 156) and minimal (controls, n = 172) carotid atherosclerosis not taking hormone therapy in the Atherosclerosis Risk in Communities Study. Endogenous hormone status was assessed by measuring levels of estrone, total testosterone, androstenedione, dehydroepiandrosterone-sulfate (DHEAS), and sex hormone binding globulin (SHBG). Free testosterone was estimated using the free androgen index (FAI=total testosterone/SHBG). Lipid parameters assessed included total cholesterol, triglycerides, HDL-cholesterol, and LDL-cholesterol. We found that SHBG was significantly associated with a more favorable lipid profile, including lower total and LDL-cholesterol and triglycerides and higher HDL-cholesterol among controls. This association was less prominent among cases, where SHBG was only associated with higher triglycerides and lower HDL-cholesterol. FAI was associated with a more atherogenic lipid profile, including increased LDL-cholesterol among controls and increased total and LDL-cholesterol and triglycerides among cases. These relations were independent of demographic and metabolic factors and health behaviors. In contrast to controls, estrone was associated with higher total cholesterol and triglycerides among cases in multivariate analyses. Our data suggest that endogenous sex hormones may play a role in regulating lipid metabolism in post-menopausal women.
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