Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Ultrasound, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Front Endocrinol (Lausanne). 2024 Sep 20;15:1411803. doi: 10.3389/fendo.2024.1411803. eCollection 2024.
The association between Estradiol (E2) levels and abdominal aortic calcification (AAC) in postmenopausal women remains unclear.
614 postmenopausal women from the 2013-2014 NHANES survey cycle were included in this study. The study population was divided into 3 groups according to E2 tertiles: Tertile1 (2.12-3.57pg/mL), Tertile2 (3.60-7.04pg/mL), and Tertile3 (7.06-38.4pg/mL). Estrogen concentration data were natural logarithmically transformed. A Kauppila score > 5 was regarded as prominent arterial calcification and was used to define (EAAC). Logistic regression models were used to assess the association between E2 levels and EAAC prevalence. Subgroup analyses were performed to test whether the association between E2 levels and EAAC prevalence was consistent in different groups. Sensitivity analyses tested the stability of the model in women older than 45 years.
EAAC prevalence was significantly higher in Tertile1 (16.6%) than in Tertile2 (9.8%) and Tertile3 (8.3%). On a continuous scale, the adjusted model showed a 58% [OR (95%CI), 1.58 (1.02, 2.54)] increase in the risk of EAAC prevalence for per unit decrease in ln(E2). On a categorical scale, the adjusted model showed that Tertile1 and Tertile2 were 2.55 [OR (95%CI), 2.55 (1.10, 5.92)] and 1.31[OR (95%CI), 1.31(1.03, 2.57)] times higher risk of suffering from EAAC than Tertile3, respectively.
This study found that a higher prevalence of AAC in postmenopausal women is closely associated with lower serum E2 levels. Our research further underscores the importance of E2 in maintaining cardiovascular health in postmenopausal women and suggests that monitoring E2 levels may aid in the early prevention and management of AAC and related cardiovascular diseases.
雌二醇(E2)水平与绝经后妇女的腹主动脉钙化(AAC)之间的关系尚不清楚。
本研究纳入了 2013-2014 年 NHANES 调查周期中的 614 名绝经后妇女。根据 E2 三分位将研究人群分为 3 组:三分位 1(2.12-3.57pg/mL)、三分位 2(3.60-7.04pg/mL)和三分位 3(7.06-38.4pg/mL)。雌激素浓度数据进行自然对数转换。Kauppila 评分>5 被认为是明显的动脉钙化,并用于定义(EAAC)。使用逻辑回归模型评估 E2 水平与 EAAC 患病率之间的关联。进行亚组分析以检验 E2 水平与 EAAC 患病率之间的关联在不同组中是否一致。敏感性分析检验了该模型在 45 岁以上女性中的稳定性。
三分位 1(16.6%)的 EAAC 患病率明显高于三分位 2(9.8%)和三分位 3(8.3%)。在连续尺度上,调整后的模型显示,ln(E2)每降低一个单位,EAAC 患病率的风险增加 58%[比值比(95%置信区间),1.58(1.02,2.54)]。在分类尺度上,调整后的模型显示,三分位 1 和三分位 2 患 EAAC 的风险分别比三分位 3 高 2.55 倍[比值比(95%置信区间),2.55(1.10,5.92)]和 1.31 倍[比值比(95%置信区间),1.31(1.03,2.57)]。
本研究发现,绝经后妇女 AAC 患病率较高与血清 E2 水平较低密切相关。我们的研究进一步强调了 E2 在维持绝经后妇女心血管健康方面的重要性,并表明监测 E2 水平可能有助于早期预防和管理 AAC 及相关心血管疾病。