Kwapong Yaa A, Sharma Garima, Valero-Elizondo Javier, Achirica Miguel Cainzos, Ali Shozab S, Blaha Michael J, Blankstein Ron, Shapiro Michael D, Arias Lara, Budoff Matthew J, Feldman Theodore, Cury Ricardo C, Mehta Laxmi, Fialkow Jonathan, Nasir Khurram
Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA.
Am J Prev Cardiol. 2023 Mar 2;14:100479. doi: 10.1016/j.ajpc.2023.100479. eCollection 2023 Jun.
The association of sex-specific hormones with coronary computed tomography angiography(CCTA)-based plaque characteristics in women without cardiovascular disease is not well understood. We investigated the association of sex-specific hormones with coronary artery plaque characteristics in a contemporary multiracial cohort with no clinical coronary artery disease (CAD).
In this cross-sectional analysis, we utilized data from 2,325 individuals with no clinical CAD from the Miami Heart (MiHeart) study. Multivariable logistic regression models were used to investigate the association of sex hormones: sex hormone binding globulin (SHBG), dehydroepiandrosterone (DHEA), free and total testosterone, estradiol, with plaque characteristics among women and men.
Of the 1,155 women, 34.2% had any plaque and 3.4% had any high-risk plaque features (HRP) while among men ( = 1170), 63.1% had any plaque and 10.4% had HRP. Among women, estradiol and SHBG were associated with lower odds of any plaque after adjusting for age and race-ethnicity (estradiol OR per SD increase: 0.87, 95%CI: 0.76-0.98; SHBG OR per SD increase: 0.82, 95%CI: 0.72-0.93) but the significance did not persist after adjustment of cardiovascular risk factors. High free testosterone was associated with higher odds of HRP (aOR:3.48, 95%CI:1.07-11.26) but null associations for the other sex hormones with HRP, in the context of limited sample size. Among men, there were no significant associations between sex-specific hormones and plaque or HRP.
Among young to middle-aged women with no clinical CAD, increasing estradiol and SHBG were associated with lower odds of any plaque and higher free testosterone was associated with HRP. Larger cohorts may be needed to validate this.
在无心血管疾病的女性中，性别特异性激素与基于冠状动脉计算机断层扫描血管造影（CCTA）的斑块特征之间的关联尚未完全明确。我们在一个当代的无临床冠状动脉疾病（CAD）的多种族队列中，研究了性别特异性激素与冠状动脉斑块特征之间的关联。
在这项横断面分析中，我们使用了来自迈阿密心脏（MiHeart）研究的2325名无临床CAD个体的数据。多变量逻辑回归模型用于研究性激素：性激素结合球蛋白（SHBG）、脱氢表雄酮（DHEA）、游离和总睾酮、雌二醇，与女性和男性斑块特征之间的关联。
在1155名女性中，34.2%有任何斑块，3.4%有任何高危斑块特征（HRP）；而在男性（n = 1170）中，63.1%有任何斑块，10.4%有HRP。在女性中，调整年龄和种族后，雌二醇和SHBG与任何斑块的较低几率相关（雌二醇每标准差增加的OR：0.87，95%CI：0.76 - 0.98；SHBG每标准差增加的OR：0.82，95%CI：0.72 - 0.93），但在调整心血管危险因素后，这种显著性未持续。在样本量有限的情况下，高游离睾酮与HRP的较高几率相关（调整后OR：3.48，95%CI：1.07 - 11.26），而其他性激素与HRP无关联。在男性中，性别特异性激素与斑块或HRP之间无显著关联。
在无临床CAD的年轻至中年女性中，雌二醇和SHBG增加与任何斑块的较低几率相关，游离睾酮升高与HRP相关。可能需要更大的队列来验证这一点。
