A1 Journal article (refereed)
Associations of Sex Hormones and Hormonal Status With Arterial Stiffness in a Female Sample From Reproductive Years to Menopause (2021)

Laakkonen, E. K., Karppinen, J. E., Lehti, S., Lee, E., Pesonen, E., Juppi, H.-K., Kujala, U. M., Haapala, E. A., Aukee, P., Laukkanen, J. A., & Ihalainen, J. K. (2021). Associations of Sex Hormones and Hormonal Status With Arterial Stiffness in a Female Sample From Reproductive Years to Menopause. Frontiers in Endocrinology, 12, Article 765916. https://doi.org/10.3389/fendo.2021.765916

JYU authors or editors

Laakkonen, Eija
Karppinen, Jari
Lehti, Satu
Lee, Earric
Juppi, Hanna-Kaarina
Kujala, Urho
Haapala, Eero
Laukkanen, Jari
Ihalainen, Johanna

Publication details

All authors or editors: Laakkonen, Eija K.; Karppinen, Jari E.; Lehti, Satu; Lee, Earric; Pesonen, Emilia; Juppi, Hanna-Kaarina; Kujala, Urho M.; Haapala, Eero A.; Aukee, Pauliina; Laukkanen, Jari A.; et al.

Journal or series: Frontiers in Endocrinology

eISSN: 1664-2392

Publication year: 2021

Publication date: 30/11/2021

Volume: 12

Article number: 765916

Publisher: Frontiers Media SA

Publication country: Switzerland

Publication language: English

DOI: https://doi.org/10.3389/fendo.2021.765916

Publication open access: Openly available

Publication channel open access: Open Access channel

Publication is parallel published (JYX): https://jyx.jyu.fi/handle/123456789/79076

Abstract

Objective: Loss of sex hormones has been suggested to underlie menopause-associated increment in cardiovascular risk. We investigated associations of sex hormones with arterial stiffness in 19–58-years-old women. We also studied associations of specific hormonal stages, including natural menstrual cycle, cycle with combined oral contraceptives (COC) and menopausal status with or without hormone therapy (HT), with arterial stiffness.

Methods: This study includes repeated measurements of 65 healthy women representing reproductive (n=16 natural, n=10 COC-users) and menopause (n=5 perimenopausal, n=26 postmenopausal, n=8 HT-users) stages. Arterial stiffness outcomes were aortic pulse wave velocity (PWVao) and augmentation index (AIx%) assessed using Arteriograph-device. Generalized estimating equation models were constructed to investigate associations of each hormone (wide age-range models) or hormonal stage (age-group focused models) with arterial stiffness. PWVao models with cross-sectional approach, were adjusted for age, relative fitness, fat mass and mean arterial pressure, while models with longitudinal approach were adjusted for mean arterial pressure. AIx% models used the same approach for adjustments and were also adjusted for heart rate.

Results: Negative and positive associations with arterial stiffness variables were observed for estradiol and follicle-stimulating hormone, respectively, until adjustment for confounding effect of age. In naturally menstruating women, AIx% was higher at ovulation (B=3.63, p<0.001) compared to the early follicular phase. In COC-users, PWVao was lower during active (B=-0.33 - -0.57, p<0.05) than inactive pills. In menopausal women, HT-users had higher PWVao (B=1.43, p=0.03) than postmenopausal non-HT-users.

Conclusions: When using wide age-range assessments covering reproductive to menopausal lifespan it is difficult to differentiate age- and hormone-mediated associations, because age-mediated influence on arterial stiffness seemed to overrule potential hormone-mediated influences. However, hormonal status associated differentially with arterial stiffness in age-group focused analyses. Thus, the role of sex hormones cannot be excluded. Further research is warranted to resolve potential hormone-mediated mechanisms affecting arterial elasticity.

Keywords: cardiovascular diseases; women; hormonal factors; menstruation; menstrual cycle; ageing; menopause; sex hormones; hormone therapy

Free keywords: vascular aging; vascular stiffness; pulse wave analysis; reproductive hormones; menstruation; hormonal contraception; hormone replacement therapy; women’s health

Fields of science: