TY - JOUR
T1 - Influence of sex and hormone status on circulating natriuretic peptides
AU - Lam, Carolyn S.P.
AU - Cheng, Susan
AU - Choong, Karen
AU - Larson, Martin G.
AU - Murabito, Joanne M.
AU - Newton-Cheh, Christopher
AU - Bhasin, Shalender
AU - McCabe, Elizabeth L.
AU - Miller, Karen K.
AU - Redfield, Margaret M.
AU - Vasan, Ramachandran S.
AU - Coviello, Andrea D.
AU - Wang, Thomas J.
PY - 2011/8/2
Y1 - 2011/8/2
N2 - Objectives: The aim of this study was to assess the relationship between sex hormones and natriuretic peptide levels in community-based adults. Background: Women have higher circulating natriuretic peptide concentrations than men, but the mechanisms for these sex-related differences and the impact of hormone therapy are unclear. Experimental studies suggest that androgens may suppress natriuretic peptide secretion. Methods: We measured N-terminal proB-type natriuretic peptide (NT-proBNP), total testosterone, and sex hormonebinding globulin plasma levels in 4,056 men and women (mean age 40 ± 9 years) from the Framingham Heart Study Third-Generation cohort. Sex/hormone status was grouped as: 1) men; 2) post-menopausal women not receiving hormone replacement therapy; 3) pre-menopausal women not receiving hormonal contraceptives; 4) post-menopausal women receiving hormone replacement therapy; and 5) pre-menopausal women receiving hormonal contraceptives. Results: Circulating NT-proBNP levels were associated with sex/hormone status (overall p < 0.0001). Men had lower NT-proBNP levels than women of all menopause or hormone groups, and women receiving hormonal contraceptives had higher NT-proBNP levels than women who were not receiving hormone therapy (all p < 0.0001). These relationships remained significant after adjusting for age, body mass index, and cardiovascular risk factors. Across sex/hormone status groups, free testosterone (FT) levels decreased and sex hormonebinding globulin levels increased in tandem with increasing NT-proBNP levels. In sex-specific analyses, NT-proBNP levels decreased across increasing quartiles of FT in men (p for trend <0.01) and women (p for trend <0.0001). Adjustment for FT markedly attenuated the association between sex/hormone status and NT-proBNP concentrations. Conclusions: These findings suggest that lower levels of circulating androgens and the potentiating effect of exogenous female hormone therapy contribute to the higher circulating NT-proBNP concentrations in women.
AB - Objectives: The aim of this study was to assess the relationship between sex hormones and natriuretic peptide levels in community-based adults. Background: Women have higher circulating natriuretic peptide concentrations than men, but the mechanisms for these sex-related differences and the impact of hormone therapy are unclear. Experimental studies suggest that androgens may suppress natriuretic peptide secretion. Methods: We measured N-terminal proB-type natriuretic peptide (NT-proBNP), total testosterone, and sex hormonebinding globulin plasma levels in 4,056 men and women (mean age 40 ± 9 years) from the Framingham Heart Study Third-Generation cohort. Sex/hormone status was grouped as: 1) men; 2) post-menopausal women not receiving hormone replacement therapy; 3) pre-menopausal women not receiving hormonal contraceptives; 4) post-menopausal women receiving hormone replacement therapy; and 5) pre-menopausal women receiving hormonal contraceptives. Results: Circulating NT-proBNP levels were associated with sex/hormone status (overall p < 0.0001). Men had lower NT-proBNP levels than women of all menopause or hormone groups, and women receiving hormonal contraceptives had higher NT-proBNP levels than women who were not receiving hormone therapy (all p < 0.0001). These relationships remained significant after adjusting for age, body mass index, and cardiovascular risk factors. Across sex/hormone status groups, free testosterone (FT) levels decreased and sex hormonebinding globulin levels increased in tandem with increasing NT-proBNP levels. In sex-specific analyses, NT-proBNP levels decreased across increasing quartiles of FT in men (p for trend <0.01) and women (p for trend <0.0001). Adjustment for FT markedly attenuated the association between sex/hormone status and NT-proBNP concentrations. Conclusions: These findings suggest that lower levels of circulating androgens and the potentiating effect of exogenous female hormone therapy contribute to the higher circulating NT-proBNP concentrations in women.
KW - hormones
KW - natriuretic peptides
KW - sex
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UR - http://www.scopus.com/inward/citedby.url?scp=79960924613&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2011.03.042
DO - 10.1016/j.jacc.2011.03.042
M3 - Article
C2 - 21798425
AN - SCOPUS:79960924613
VL - 58
SP - 618
EP - 626
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 6
ER -