In this study, data from the Estrogen in the Prevention of Atherosclerosis Trial (EPAT) longitudinal study was used to evaluate changes in sex hormone concentrations in relation to atherosclerosis progression in women. A total of 180 post-menopausal women an average of 61.5 years of age were included in the study. Ninety-one were randomized to 17β-estradiol and 89 to placebo. Women treated with estrogens showed increased concentrations of total estradiol, free estradiol, estrone, sex hormone binding globulin (SHBG), and decreased free testosterone levels. Results demonstrated that, over 2 years, increased estrogens and SHBG levels in post-menopausal women with and without estrogen therapy had a clearly positive effect on intima-media thickness, even after controlling for age and body mass index. Estrogens and SHBG were also found to be significantly inversely related with LDL cholesterol and positively associated with HDL cholesterol (p<0.0001), whereas free testosterone was positively related to LDL cholesterol and inversely related to HDL cholesterol (p<0.003). In fact, women with high free estradiol (on estrogen therapy or not) and SHBG and decreased free testosterone had the largest reduction in carotid intima media thickness progression. This study provides evidence that estrogens and SHBG have a significant, beneficial impact on the lipid profile and atherosclerosis progression in post-menopausal women.
Documentation centre