Cardiometabolic Risk Factors and Endogenous Sex Hormones in Postmenopausal Women: A Cross-Sectional Study

Context It is uncertain which cardiovascular risk factors are associated with sex hormone levels in postmenopausal women. Objective To investigate the association between cardiometabolic risk factors and sex hormones in a cross-sectional observational population study. Study participants and setting In this Swedish population study, the participants were physically examined in 2002-2004, and endogenous sex hormones were analyzed by liquid chromatography-tandem mass spectrometry. Women ≥55 years old with estradiol levels below 20 pg/mL and not using any hormonal therapy were eligible for inclusion in the study (N=146). Variable selection and bootstrap stability analyses were performed and linear regression models presented, with each of the eight hormones as outcome variables. Results Body mass index (BMI) was positively associated with estradiol (β=0.054, P<0.001), but negatively associated with 17-α-hydroxyprogesterone (β=-0.023, P=0.028). Waist-to-hip ratio was negatively associated with dihydrotestosterone (β=-2.195, P=0.002) and testosterone (β=-1.541, P=0.004). HOMA-Ir was positively associated with androstenedione (β=0.071, P=0.032), estradiol (β=0.091, P=0.009), estrone (β=0.075, P=0.009), and 17-α-hydroxyprogesterone (β=0.157, P=0.001). Age was positively associated with testosterone (β=0.017, P=0.042). C-reactive protein showed an inverse association with progesterone (β=-0.028, P=0.037). Lower LDL-cholesterol was associated with higher estradiol levels (β=-0.093, P=0.049), whereas lower triglycerides were associated with higher concentrations of dihydrotestosterone (β=-0.208, P=0.016). Conclusion In postmenopausal women, waist-hip ratio was strongly inversely associated with androgens, while BMI was positively associated with estrogens.