Thurston RC, et al. - Researchers examined the associations of mass spectrometry–assessed estrone (E1), estradiol (E2), testosterone (T), and SHBG with subclinical cardiovascular disease (CVD) in women. They saw an association between endogenous E1 levels and endothelial function. Also, a relation was noted between E2 and vascular remodeling. These data are suggestive of these estrogens having distinct roles. Based on the vessel under study, SHBG and free T were shown to have complex roles.

Methods

• Subclinical CVD measurements were performed in 304 perimenopausal and postmenopausal women aged 40 to 60 years.
• Researchers used liquid chromatography–tandem mass spectrometry to assay E1, E2, and T; free T (FT) was estimated using ensemble allostery models.
• They used regression models adjusted for CVD risk factors.
• Main outcomes included carotid artery intima media thickness, interadventitial diameter (IAD), plaque, and brachial flow mediated dilation (FMD).

Results

• Findings demonstrated association between higher E1 and higher FMD [β(SE) = 0.77 (0.37), P=0.04], indicating better endothelial function.
• They found higher E2 was associated with lower IAD [β(SE) = -0.07 (0.02), P= 0.004], suggesting less carotid remodeling.
• Data showed higher SHBG was associated with higher FMD [β(SE) = 1.31 (0.40), P= 0.001], yet higher IAD [β(SE) = 0.15 (0.06), P=0.02] and plaque [OR (95% CI) = 1.84 (1.16 to 2.91), P=0.009]; FT demonstrated a similar yet inverse pattern of links as SHBG.
• They observed better endothelial function, yet greater carotid remodeling and plaque, in relation to higher SHBG and lower FT.