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Submitted on April 7, 2005
Accepted on August 1, 2005
Departments of Epidemiology and Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109 (MFS, MJ, RL, DM), University of California Davis (BL), University of Pittsburgh, (KST, KAM), Massachusetts General Hospital (RP)
* To whom correspondence should be addressed. E-mail: mfsowers{at}umich.edu.
Goal: In women, relate annually-measured endogenous androgens to hemostatic and inflammation markers, longitudinally.
Methods: 3302 participants from the Study of Women's Health Across the Nation (SWAN), aged 42-52 yr at baseline and self-identified as African American (28%), Caucasian (47%), Chinese (8%), Hispanic (8%), or Japanese (9%) were evaluated for testosterone (T), dehydroepiandrosterone sulfate (DHEAS), and sex hormone binding globulin (SHBG) at 4 time points in 5 yr. Cardiovascular disease markers were fibrinogen, activated Factor VII-c, C-reactive protein (hsC-RP), and the fibrolytic factors, plasminogen activator inhibitor type 1 (PAI-1) and tissue plasminogen activator (tPA).
Results: Testosterone and Free Androgen Index (FAI) were highly positively associated with PAI-1 and t(PA) and FAI was highly and positively associated with hsC-RP. Lower SHBG levels, associated with greater bioavailable testosterone, were significantly associated with higher levels of PAI-1, t(PA), hsC-RP, and Factor VII-c. SHBG was markedly lower in Chinese and Japanese women, resulting in FAI values that, on average, were higher among Chinese and Japanese women compared with African-American, Caucasian and Hispanic women.
Implications. There were strong, positive associations of androgens with fibrolytic and inflammation markers, even after considering age, body size, smoking and race/ethnicity. It is important to study androgens, their precursors and their carrier protein as part of the risk profile for heart disease in mid-aged women.
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