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: This work aimed to investigate the association between cardiometabolic risk factors and sex hormones in a cross-sectional, observational population study. Methods: In this Swedish population study, participants were physically examined from 2002 to 2004, and endogenous sex hormones were analyzed by liquid chromatography-tandem mass spectrometry. Women aged 55 years or older 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 8 hormones as outcome variables. Results: Body mass index (BMI) was positively associated with estradiol (beta = 0.054, P < .001), but negatively associated with 17-alpha-hydroxyprogesterone (beta = -0.023, P = .028). Waist-to-hip ratio (WHR) was negatively associated with dihydrotestosterone (beta = -2.195, P = .002) and testosterone (beta = -1.541, P = .004). The homeostatic model assessment of insulin resistance was positively associated with androstenedione (beta = 0.071, P = .032), estradiol (beta = 0.091, P = .009), estrone (beta = 0.075, P = 0.009), and 17-alpha-hydroxyprogesterone (beta = 0.157 P = .001). Age was positively associated with testosterone (6 = 0.017, P = .042). C-reactive protein showed an inverse association with progesterone (beta = -0.028, P = .037). Lower low-density lipoprotein cholesterol was associated with higher estradiol levels (beta = -0.093, P = .049), whereas lower triglycerides were associated with higher concentrations of dihydrotestosterone (beta = -0.208, P = .016). Conclusion: In postmenopausal women, WHR was strongly inversely associated with androgens, while BMI was positively associated with estrogens.