Kische Hanna, Gross Stefan, Wallaschofski Henri, Völzke Henry, Dörr Marcus, Nauck Matthias, Felix Stephan B, Haring Robin
Institute of Clinical Chemistry and Laboratory Medicine, Germany.
German Centre for Cardiovascular Research (DZHK), Greifswald, Germany; Department of Cardiology, University Medicine Greifswald, Germany.
Atherosclerosis. 2016 Apr;247:193-200. doi: 10.1016/j.atherosclerosis.2016.02.020. Epub 2016 Feb 22.
Most of the observed associations of androgens and sex hormone-binding globulin (SHBG) with subclinical cardiovascular disease (CVD) stem from selected study samples with immunoassay-based hormone measurements. Thus, we used a large population-based sample with total testosterone (TT) and androstenedione (ASD) concentrations measured by liquid chromatography-tandem mass spectrometry.
Data of 2140 individuals (mean age: 60,8 years) from the cohort Study of Health in Pomerania were assessed at baseline and 5-year follow-up.
Multivariable regression models were implemented to assess cross-sectional and longitudinal associations of TT, free testosterone (fT), ASD, SHBG and dehydroepiandrosterone-sulphate (DHEAS) with measures of subclinical CVD including intima media thickness (IMT), carotid plaques, left ventricular mass (LVM), fractional shortening (FS), relative wall thickness (RWT), and left ventricular geometry.
Cross-sectional analyses yielded an association of TT with IMT in women (β-coefficient per log unit increase: 0.02; 95% CI: 0.007; 0.45) and ASD with FS in both sexes (men: β-coefficient: -2.94; 95% CI: -4.75; -1.12; women: β-coefficient: 1.64; 95% CI: 0.55; 2.73). In longitudinal analyses, DHEAS was positively associated with FS change (β-coefficient: 2.34; 95% CI: -0.59; 4.08). In women, SHBG was positively associated with incident plaques (Q1 vs. Q3 (Ref.): β-coefficient: 1.35; 95% CI: 1.04; 1.74). In both sexes, longitudinal analyses showed no consistent association of TT with subclinical CVD.
Despite several sex-specific associations of androgens and SHBG with subclinical CVD, the present representative study for the age group ≥45 years among men and women from the general population detected no consistent associations in longitudinal analyses.
雄激素和性激素结合球蛋白（SHBG）与亚临床心血管疾病（CVD）之间观察到的大多数关联都源于基于免疫测定法进行激素测量的特定研究样本。因此，我们使用了一个基于大规模人群的样本，通过液相色谱 - 串联质谱法测量总睾酮（TT）和雄烯二酮（ASD）的浓度。
对来自波美拉尼亚健康队列研究的2140名个体（平均年龄：60.8岁）的数据在基线和5年随访时进行评估。
采用多变量回归模型评估TT、游离睾酮（fT）、ASD、SHBG和硫酸脱氢表雄酮（DHEAS）与亚临床CVD指标之间的横断面和纵向关联，这些指标包括内膜中层厚度（IMT）、颈动脉斑块、左心室质量（LVM）、缩短分数（FS）、相对壁厚度（RWT）和左心室几何形状。
横断面分析显示，女性中TT与IMT有关联（每增加一个对数单位的β系数：0.02；95%置信区间：0.007；0.45），男女两性中ASD与FS有关联（男性：β系数： - 2.94；95%置信区间： - 4.75； - 1.12；女性：β系数：1.64；95%置信区间：0.55；2.73）。在纵向分析中，DHEAS与FS变化呈正相关（β系数：2.34；95%置信区间： - 0.59；4.08）。在女性中，SHBG与新发斑块呈正相关（第一四分位数与第三四分位数（参考值）相比：β系数：1.35；95%置信区间：1.04；1.74）。在男女两性中，纵向分析显示TT与亚临床CVD没有一致的关联。
尽管雄激素和SHBG与亚临床CVD存在一些性别特异性关联，但本针对普通人群中≥45岁年龄组的代表性研究在纵向分析中未发现一致的关联。
