Estrone, sex hormone binding globulin and lipid profiles in older women: an observational study

Abstract

Objective

We investigated whether estrone and sex hormone binding globulin (SHBG) concentrations are associated with lipid concentrations in older postmenopausal women.

Methods

This was a cross-sectional study of 6358 Australian women, aged 70–95 years, recruited between 2010 and 2014. Associations between estrone and SHBG and lipid concentrations were examined in participants not using medications that influence estrogen concentrations or lipid-lowering therapy. Linear regression models included age, body mass index, smoking, alcohol consumption, renal function and diabetes, with the lowest quartile (Q1) as the reference for estrone and SHBG.

Results

The study included 3231 participants with median age of 74.0 (interquartile range 71.7–77.9) years. Estrone concentration Q3 and Q4 were positively associated with high-density lipoprotein cholesterol (HDL-C) (p = 0.017 and p = 0.046, respectively). Inverse associations were seen for estrone Q4 with total cholesterol (p = 0.018), Q2 and Q4 with non-HDL-C (p = 0.045 and p = 0.002, respectively) and Q3 and Q4 with triglycerides (p = 0.030 and p = 0.001, respectively). For SHBG, Q2, Q3 and Q4 were positively associated with HDL-C (all p < 0.001), and inversely with non-HDL-C (all p = 0.001) and triglycerides (all p < 0.001).

Conclusions

Estrone and SHBG are associated with lipid concentrations in older women. SHBG, but not estrone, may provide additional clinical predictive utility for the assessment of cardiometabolic disease risk in older women.

摘要

目的：我们调查了老年绝经后妇女的雌酮和性激素结合球蛋白(SHBG)浓度是否与血脂浓度有关。

方法：这是一项横断面研究, 研究对象为2010年至2014年间招募的6358名年龄在70-95岁之间的澳大利亚女性。在没有使用影响雌激素浓度或降脂治疗的药物的参与者中, 研究了雌酮和SHBG与血脂浓度的关系。线性回归模型包括年龄、体重指数、吸烟、饮酒、肾功能和糖尿病, 最低四分位数(Q1)作为雌酮和SHBG的参考。

结果：这项研究包括3231名参与者, 中位年龄为74.0岁(四分位数间距为71.7-77.9岁)。雌酮浓度Q3和Q4与高密度脂蛋白胆固醇(HDL-C)呈正相关(P值分别为0.017和0.046)。雌酮Q4与总胆固醇呈负相关(p=0.018), Q2和Q4与非高密度脂蛋白胆固醇呈负相关(分别为p=0.045和p=0.002), Q3和Q4与甘油三酯呈负相关(分别为p=0.030和p=0.001)。SHBG患者Q2、Q3、Q4与高密度脂蛋白胆固醇呈正相关(所有P<0.001), 与非高密度脂蛋白胆固醇、甘油三酯呈负相关(所有P<0.001), 与甘油三酯呈负相关(所有P<0.001)。

结论：雌酮和SHBG与老年女性的血脂浓度有关。SHBG, 而不是雌酮, 可能为老年女性心脏代谢性疾病风险的评估提供额外的临床预测作用。

Keywords:

• Menopause
• estrone
• sex hormone binding globulin
• cholesterol
• lipids

Potential conflict of interest

S.R.D. has been paid for developing and delivering educational presentations for Besins Healthcare, Abbott, Mayne Pharma, BioFemme and Lawley Pharmaceuticals; has been on Advisory Boards for Theramex, Abbott Laboratories, Mayne Pharma, Gedon Richter and Roche Diagnostics; has been a consultant to Lawley Pharmaceuticals, Southern Star Research and Que Oncology; and has received institutional grant funding for Que Oncology and for Ovova Bio research. A.M.T. reports honoraria for Advisory Board participation from Amgen; Data Monitoring Committee membership from Merck, The Medicines Company and Novartis; and lectures from Pfizer.

Data availability statement

After deidentification (i.e. text, tables, figures and Supplementary material), individual participant data will be made available. On application, meta-data and a data dictionary will be made available to others. The ASPREE study protocol is available on the ASPREE website. The ASPREE trial statistical analysis plan is published elsewhere [37]. On request, a copy of the clinical trial consent form can be made available. Requests for data access will be via the ASPREE Principal Investigators, and details for applications provided through SHOW sub-study data on sex hormones can be requested through this system with approval by the corresponding author. Data will be made available to investigators whose proposed use of the data, registered as a project through the ASPREE Access Management Site, has been approved by a review committee. Access will be through a secure web-based data portal (the ASPREE Safe Haven system), based at Monash University (Monash, VIC, Australia).

Additional information

Funding

The ASPREE trial was supported by the National Institute on Aging and the National Cancer Institute at the National Institutes of Health [Grant U01AG029824]; the National Health and Medical Research Council (NHMRC) of Australia [Grant 34047], [Grant 1127060]; Monash University (Australia); and the Victorian Cancer Agency (Australia). The ASPREE Healthy Ageing Biobank was funded by the CSIRO (Flagship Grant); the National Cancer Institute [Grant U01 AG029824]; and Monash University. This analysis of sex hormones was funded by an NHMRC of Australia Project Grant [No. 1105305]. S.R.D. is an Australian NHMRC Senior Principal Research Fellow [Grant 1135843].