Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States.
Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States.
Thromb Haemost. 2018 Nov;118(11):1940-1950. doi: 10.1055/s-0038-1673613. Epub 2018 Oct 8.
Exogenous hormone treatments in women (oral contraceptives and hormone replacement therapy [HRT]) are established risk factors for venous thromboembolism (VTE), but less is known about associations between plasma levels of endogenous hormones and VTE risk. We examined the association of baseline dehydroepiandrosterone sulphate (DHEAS), testosterone and sex hormone-binding globulin (SHBG) with risk of future VTE in men and post-menopausal women in the Atherosclerosis Risk in Communities Study. Testosterone, DHEAS and SHBG were measured in plasma samples collected in 1996 to 1998. Cox proportional hazards models were used to estimate hazard ratios for incident VTE adjusting for age, race/ethnicity, body mass index, height, smoking, estimated glomerular filtration rate and C-reactive protein. All analyses were stratified by sex and by current HRT use in women. Among 3,051 non-HRT-using women, 1,414 HRT-using women and 3,925 men at risk at baseline, 184, 62 and 206 experienced incident VTE after a median follow-up of 17.6 years. Plasma hormones were not associated with incidence of VTE among men and non-HRT-using women, although lower plasma DHEAS, when modelled using quartiles or restricted cubic splines, was associated with higher risk of VTE among HRT-using women. This study does not support the existence of an important association between plasma concentrations of endogenous testosterone, DHEAS or SHBG with risk of VTE in middle-aged to older men or post-menopausal women not using HRT.
外源性激素治疗（口服避孕药和激素替代疗法[HRT]）已被确认为静脉血栓栓塞（VTE）的危险因素，但人们对内源性激素与 VTE 风险之间的关系知之甚少。我们在动脉粥样硬化风险社区研究（Atherosclerosis Risk in Communities Study）中，检查了基线脱氢表雄酮硫酸酯（DHEAS）、睾酮和性激素结合球蛋白（SHBG）与男性和绝经后女性未来 VTE 风险的关系。在 1996 年至 1998 年采集的血浆样本中测量了睾酮、DHEAS 和 SHBG。使用 Cox 比例风险模型估计了发生 VTE 的风险比，该模型通过年龄、种族/民族、体重指数、身高、吸烟、估计肾小球滤过率和 C-反应蛋白进行调整。所有分析均按性别和女性当前 HRT 使用情况进行分层。在 3051 名未使用 HRT 的女性、1414 名使用 HRT 的女性和 3925 名有风险的男性中，184、62 和 206 人在中位随访 17.6 年后发生了 VTE。在男性和未使用 HRT 的女性中，血浆激素与 VTE 的发生无关，尽管使用四分位数或限制立方样条模型对 DHEAS 进行建模时，DHEAS 水平较低与 HRT 使用者中 VTE 风险较高相关。本研究不支持内源性睾酮、DHEAS 或 SHBG 与未使用 HRT 的中年至老年男性或绝经后女性 VTE 风险之间存在重要关联。
