Associations Among Androgens, Estrogens, and Natriuretic Peptides in Young Women. Observations From the Dallas Heart Study

Alice Y. Chang, Shuaib M Abdullah, Tulika Jain, Harold G. Stanek, Sandeep R Das, Darren K McGuire, Richard J. Auchus, James A de Lemos

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102 Citations (Scopus)

Abstract

Objectives: We sought to determine if natriuretic peptides are associated with estrogen and androgen status in a population study of young women without known cardiac disease. Background: Circulating concentrations of plasma B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are higher in women than in men, and they may be influenced by estrogens and androgens. Methods: Cardiac magnetic resonance imaging, dual energy X-ray absorbtiometry, and measurements of BNP, NT-proBNP, follicle-stimulating hormone (FSH), total testosterone, and sex hormone-binding globulin (SHBG), were performed in 682 women (ages 35 to 49 years) participating in the Dallas Heart Study. Results: In multivariable analyses adjusting for age, race/ethnicity, body mass index (BMI), serum creatinine, left ventricular mass and left ventricular ejection fraction <55%, menopausal status, and FSH were not associated with BNP and NT-proBNP. In contrast, higher SHBG was associated with higher BNP and NT-proBNP, while the free androgen index and calculated free testosterone were inversely associated with BNP and NT-proBNP (p < 0.0001 for each). Addition of SHBG or any measure of free testosterone to the multivariable models modified the effect of BMI and lean mass, such that measures of body composition were no longer significantly associated with BNP or NT-proBNP. Conclusions: Among young women, measures of free testosterone were independently and inversely associated with BNP and NT-proBNP. These results suggest that circulating free testosterone, not estradiol, mediates gender differences in natriuretic peptides. In addition, the association between higher BMI and lean body mass with natriuretic peptides may be mediated by testosterone.

Original languageEnglish (US)
Pages (from-to)109-116
Number of pages8
JournalJournal of the American College of Cardiology
Volume49
Issue number1
DOIs
StatePublished - Jan 2 2007

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Natriuretic Peptides
Brain Natriuretic Peptide
Androgens
Estrogens
Testosterone
Sex Hormone-Binding Globulin
Body Mass Index
Follicle Stimulating Hormone
pro-brain natriuretic peptide (1-76)
Body Composition
Stroke Volume
Estradiol
Heart Diseases
Creatinine
Magnetic Resonance Imaging
X-Rays
Serum
Population

ASJC Scopus subject areas

  • Nursing(all)

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Associations Among Androgens, Estrogens, and Natriuretic Peptides in Young Women. Observations From the Dallas Heart Study. / Chang, Alice Y.; Abdullah, Shuaib M; Jain, Tulika; Stanek, Harold G.; Das, Sandeep R; McGuire, Darren K; Auchus, Richard J.; de Lemos, James A.

In: Journal of the American College of Cardiology, Vol. 49, No. 1, 02.01.2007, p. 109-116.

Research output: Contribution to journalArticle

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abstract = "Objectives: We sought to determine if natriuretic peptides are associated with estrogen and androgen status in a population study of young women without known cardiac disease. Background: Circulating concentrations of plasma B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are higher in women than in men, and they may be influenced by estrogens and androgens. Methods: Cardiac magnetic resonance imaging, dual energy X-ray absorbtiometry, and measurements of BNP, NT-proBNP, follicle-stimulating hormone (FSH), total testosterone, and sex hormone-binding globulin (SHBG), were performed in 682 women (ages 35 to 49 years) participating in the Dallas Heart Study. Results: In multivariable analyses adjusting for age, race/ethnicity, body mass index (BMI), serum creatinine, left ventricular mass and left ventricular ejection fraction <55{\%}, menopausal status, and FSH were not associated with BNP and NT-proBNP. In contrast, higher SHBG was associated with higher BNP and NT-proBNP, while the free androgen index and calculated free testosterone were inversely associated with BNP and NT-proBNP (p < 0.0001 for each). Addition of SHBG or any measure of free testosterone to the multivariable models modified the effect of BMI and lean mass, such that measures of body composition were no longer significantly associated with BNP or NT-proBNP. Conclusions: Among young women, measures of free testosterone were independently and inversely associated with BNP and NT-proBNP. These results suggest that circulating free testosterone, not estradiol, mediates gender differences in natriuretic peptides. In addition, the association between higher BMI and lean body mass with natriuretic peptides may be mediated by testosterone.",
author = "Chang, {Alice Y.} and Abdullah, {Shuaib M} and Tulika Jain and Stanek, {Harold G.} and Das, {Sandeep R} and McGuire, {Darren K} and Auchus, {Richard J.} and {de Lemos}, {James A}",
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T1 - Associations Among Androgens, Estrogens, and Natriuretic Peptides in Young Women. Observations From the Dallas Heart Study

AU - Chang, Alice Y.

AU - Abdullah, Shuaib M

AU - Jain, Tulika

AU - Stanek, Harold G.

AU - Das, Sandeep R

AU - McGuire, Darren K

AU - Auchus, Richard J.

AU - de Lemos, James A

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N2 - Objectives: We sought to determine if natriuretic peptides are associated with estrogen and androgen status in a population study of young women without known cardiac disease. Background: Circulating concentrations of plasma B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are higher in women than in men, and they may be influenced by estrogens and androgens. Methods: Cardiac magnetic resonance imaging, dual energy X-ray absorbtiometry, and measurements of BNP, NT-proBNP, follicle-stimulating hormone (FSH), total testosterone, and sex hormone-binding globulin (SHBG), were performed in 682 women (ages 35 to 49 years) participating in the Dallas Heart Study. Results: In multivariable analyses adjusting for age, race/ethnicity, body mass index (BMI), serum creatinine, left ventricular mass and left ventricular ejection fraction <55%, menopausal status, and FSH were not associated with BNP and NT-proBNP. In contrast, higher SHBG was associated with higher BNP and NT-proBNP, while the free androgen index and calculated free testosterone were inversely associated with BNP and NT-proBNP (p < 0.0001 for each). Addition of SHBG or any measure of free testosterone to the multivariable models modified the effect of BMI and lean mass, such that measures of body composition were no longer significantly associated with BNP or NT-proBNP. Conclusions: Among young women, measures of free testosterone were independently and inversely associated with BNP and NT-proBNP. These results suggest that circulating free testosterone, not estradiol, mediates gender differences in natriuretic peptides. In addition, the association between higher BMI and lean body mass with natriuretic peptides may be mediated by testosterone.

AB - Objectives: We sought to determine if natriuretic peptides are associated with estrogen and androgen status in a population study of young women without known cardiac disease. Background: Circulating concentrations of plasma B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are higher in women than in men, and they may be influenced by estrogens and androgens. Methods: Cardiac magnetic resonance imaging, dual energy X-ray absorbtiometry, and measurements of BNP, NT-proBNP, follicle-stimulating hormone (FSH), total testosterone, and sex hormone-binding globulin (SHBG), were performed in 682 women (ages 35 to 49 years) participating in the Dallas Heart Study. Results: In multivariable analyses adjusting for age, race/ethnicity, body mass index (BMI), serum creatinine, left ventricular mass and left ventricular ejection fraction <55%, menopausal status, and FSH were not associated with BNP and NT-proBNP. In contrast, higher SHBG was associated with higher BNP and NT-proBNP, while the free androgen index and calculated free testosterone were inversely associated with BNP and NT-proBNP (p < 0.0001 for each). Addition of SHBG or any measure of free testosterone to the multivariable models modified the effect of BMI and lean mass, such that measures of body composition were no longer significantly associated with BNP or NT-proBNP. Conclusions: Among young women, measures of free testosterone were independently and inversely associated with BNP and NT-proBNP. These results suggest that circulating free testosterone, not estradiol, mediates gender differences in natriuretic peptides. In addition, the association between higher BMI and lean body mass with natriuretic peptides may be mediated by testosterone.

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