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Lower estradiol, SHBG levels related to ectopic CV fat volumes in women at midlife

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WASHINGTON — Endogenous sex hormones were associated with ectopic cardiovascular fat volumes in women during varying stages of menopause, according to data presented at the 25th annual meeting of The North American Menopause Society.

Specific location of ectopic cardiovascular fat (ECF) affected some hormones more than others, Samar R. El Khoudary, PhD, MPH, of the University of Pittsburgh Graduate School of Public Health, and colleagues found in an investigation of patients from the Study of Women’s Health Across the Nation (SWAN) ECF Ancillary Study.

“Levels of endogenous sex hormones in women at midlife may contribute to cardiovascular fat volume and actually render women more vulnerable to coronary heart disease at midlife due to the proximity of this fat to the heart,” El Khoudary said.

The researchers looked at 450 women (mean age, 50.7 years; 62.7% white; 61.8% pre-/early perimenopausal) not on hormone therapy with data on epicardial adipose tissue (EAT), pericardial adipose tissue (PAT) or perivascular adipose tissue (PVAT) ECF depots.

Cross-sectional associations between volumes of EAT, PAT and PVAT and endogenous sex hormone estradiol (E2), free androgen index (FAI) and sex hormone-binding globulin were evaluated separately.  

ECF depots were quantified through electron beam CT scans. To achieve normality, ECF volumes and sex hormones were log transformed; linear regression models were used to assess relationships.

Higher levels of E2 were associated with less EAT (–0.05; P=.01) and PAT (–0.1; P=.004) but not PVAT in unadjusted models. Higher levels of SHGB were associated with reduced volume of all three depots (EAT, –0.18; PAT, –0.25; PVAT, –0.2; P<.001 for all three). Higher levels of FAI, meanwhile, were significantly associated with increased volume of all three depots (EAT, 0.12; PAT, 0.2; PVAT, 0.16; P<.001 for all three).

Higher levels of E2 were still associated with lower PAT (–0.06; P<.03) in fully adjusted models, as were higher levels of FAI with higher PVAT (0.08; P<.0003) and higher levels of SGHB with decreased volume for all three depots (EAT, –0.07, P<.03; PAT, –0.13, P<.008; PVAT, –0.11, P<.0002.)

“The main limitation of our study was the cross-sectional nature, and we don’t have a direct measure for available testosterone,” El Khoudary said. “However, this is the first study to evaluate whether volumes of cardiovascular fat associated with endogenous sex hormones in women at midlife, and we used a well-characterized cohort from the SWAN Study.” – by Allegra Tiver

For more information:

El Khoudary SR. Abstract S-3. Presented at: The North American Menopause Society Annual Meeting; Oct. 15-18, 2014; Washington, D.C.

Disclosure: El Khoudary reports no relevant financial disclosures. Please see the SWAN study for a full list of researchers’ financial disclosures.