Trajectories of estradiol and follicle-stimulating hormone over the menopause transition and early markers of atherosclerosis after menopause

Aim The purpose of this study was to assess associations between distinct patterns of circulating estradiol (E2) and follicle-stimulating hormone (FSH) over the menopause transition (MT) and subclinical measures of atherosclerosis after menopause. Methods and results Four temporal patterns of E2 dec...

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Published in:European journal of preventive cardiology 2016-05, Vol.23 (7), p.694-703
Main Authors: El Khoudary, Samar R, Santoro, Nanette, Chen, Hsiang-Yu, Tepper, Ping G, Brooks, Maria M, Thurston, Rebecca C, Janssen, Imke, Harlow, Sioban D, Barinas-Mitchell, Emma, Selzer, Faith, Derby, Carol A, Jackson, Elizabeth A, McConnell, Daniel, Matthews, Karen A
Format: Article
Language:English
Subjects:
Adult
Aging - blood
Aging - ethnology
Asian Americans
Atherosclerosis - blood
Atherosclerosis - diagnosis
Atherosclerosis - ethnology
Biomarkers - blood
Carotid Intima-Media Thickness
European Continental Ancestry Group
Female
Follicle Stimulating Hormone - blood
Follow-Up Studies
Hispanic Americans
Humans
Menopause - blood
Menopause - ethnology
Middle Aged
Risk Factors
United States - epidemiology
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Summary:Aim The purpose of this study was to assess associations between distinct patterns of circulating estradiol (E2) and follicle-stimulating hormone (FSH) over the menopause transition (MT) and subclinical measures of atherosclerosis after menopause. Methods and results Four temporal patterns of E2 decline (Low: low before and after final menstrual period (FMP); Medium: medium before and high after FMP; High-early decline: high prior to FMP and early decline thereafter; High-late decline: high prior to FMP and late decline thereafter) and three of FSH rise (Low, Medium, High) over 9.6 years across FMP were identified and linked to carotid intima-media-thickness (IMT), adventitial diameter (AD), and presence of carotid plaque (cPlaque) measured after menopause at the 12th annual visit (visit 12). Participants were 856 women (age at visit 12 = 59.5 ± 2.7 years) from the Study of Women's Health Across the Nation (SWAN), who never reported a stroke or a heart attack. In models adjusted for visit 12 or baseline cardiovascular disease (CVD) risk factors, odds of having any cPlaque were ∼43% lower among women with the High-early decline E2 trajectory compared to women with the Low E2 trajectory. In contrast, women with the Medium E2 trajectory had significantly higher IMT than those with the Low E2 trajectory adjusting for visit 12 CVD risk factors. Interestingly, adjusting for baseline CVD risk factors attenuated this association. The Low FSH group had lower IMT than the Medium and High FSH groups (p ≤ 0.05) in all models. Conclusion During MT, women are subjected to hormonal alterations that could potentially increase their risk of developing CVD after menopause.
ISSN:2047-4873
2047-4881
DOI:10.1177/2047487315607044