Sex steroids, sex hormone-binding globulin and levels of N-terminal pro-brain natriuretic peptide in postmenopausal women.

BACKGROUND

Amino-terminal pro-B-type natriuretic peptide (NT-proBNP) has a well-documented prognostic value for cardiovascular disease and sex-hormones are suggested to modulate NT-proBNP levels.

OBJECTIVE

To examine whether endogenous sex-hormones and sex hormone-binding globulin (SHBG) are associated with NT-proBNP levels in postmenopausal women free of clinical cardiovascular diseases.

METHODS

Total estradiol (E), total testosterone (TT), androstenedione (AD), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG) and NT-proBNP were assessed in 4112 postmenopausal women free of cardiovascular diseases from the prospective population-based Rotterdam Study. Free androgen index (FAI) was calculated as ratio of TT to SHBG concentration. TT, AD, DHEA(S), SHBG, FAI and NT-proBNP were natural log transformed. Regression coefficients and 95% Confidence Intervals (CI) were calculated using multivariable linear regression models adjusting for confounders.

RESULTS

In models adjusted for multiple confounders (age, reproductive, life style and cardiovascular risk factors) higher SHBG (per 1 SD increase, β = 0.15, 95% CI = 0.12, 0.18), and lower levels of TT (per 1 SD increase, β = -0.05, 95%CI = -0.08, -0.02), FAI (per 1 SD increase, β = -0.13, 95%CI = -0.15, -0.09), DHEAS (per 1 SD increase, β = -0.06, 95% CI = -0.09, -0.04) and DHEA (per 1 SD increase, β = -0.06, 95%CI = -0.09, -0.04) were associated with higher levels of NT-proBNP. However, no consistent association was found between E and AD and NT-proBNP levels. Additionally, stratification by BMI did not affect any of observed associations.

CONCLUSION

Our findings support the hypothesis that higher androgens might be associated with lower natriuretic peptide levels in postmenopausal women.