Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
Diab Vasc Dis Res. 2021 Mar-Apr;18(2):14791641211002475. doi: 10.1177/14791641211002475.
Total and free testosterone and sex hormone-binding globulin may affect cardiovascular prognosis in women. The objective was to study the association between sex hormones and prognosis in women with dysglycemia and high cardiovascular risk.
This epidemiological report included dysglycemic women from the Outcome Reduction with an Initial Glargine Intervention trial ( = 2848) with baseline total testosterone and sex hormone-binding globulin. Free testosterone was calculated with the Vermeulen formula. Cox regression analyses adjusted for variables including age, previous diseases and pharmacological treatments were used to estimate the association between these levels and the composite cardiovascular outcome (death from cardiovascular causes, nonfatal myocardial infarction or nonfatal stroke) and all-cause mortality per one standard deviation.
Patients (73% post-menopausal) were followed for a median of 6.1 years during which 377 cardiovascular events and 389 deaths occurred. In Cox analyses, total and free testosterone were not associated with any outcomes, but sex hormone-binding globulin was related to all-cause mortality in age adjusted (HR 1.15; 95% CI 1.06-1.24; < 0.01) and fully adjusted analyses (HR 1.14; 95% CI 1.05-1.24; < 0.01).
Increasing levels of baseline sex hormone-binding globulin were associated with an increased risk of all-cause mortality in dysglycemic women at high cardiovascular risk.
ClinicalTrials.gov no. NCT00069784.
总睾酮和游离睾酮以及性激素结合球蛋白可能会影响女性的心血管预后。本研究旨在探讨糖代谢异常且心血管风险较高的女性患者的性激素水平与预后之间的关系。
本研究纳入了来自 OUTCOME 研究的糖代谢异常女性患者（共 2848 例），这些患者在基线时检测了总睾酮和性激素结合球蛋白。游离睾酮用 Vermeulen 公式进行计算。采用 Cox 回归分析调整了年龄、既往疾病和药物治疗等变量，以评估这些水平与复合心血管结局（心血管原因死亡、非致死性心肌梗死或非致死性卒中）以及全因死亡率的相关性，每标准差的变化。
患者（73%绝经后）中位随访 6.1 年，发生了 377 例心血管事件和 389 例死亡。在 Cox 分析中，总睾酮和游离睾酮与任何结局均无关，但性激素结合球蛋白与年龄调整（HR 1.15；95%CI 1.06-1.24； < 0.01）和完全调整分析（HR 1.14；95%CI 1.05-1.24； < 0.01）中的全因死亡率相关。
糖代谢异常且心血管风险较高的女性患者中，基线性激素结合球蛋白水平升高与全因死亡率增加相关。
ClinicalTrials.gov 编号 NCT00069784。
