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Prospective Study of Endogenous Hormones and Incidence of Venous Thromboembolism: The Atherosclerosis Risk in Communities Study.

TitleProspective Study of Endogenous Hormones and Incidence of Venous Thromboembolism: The Atherosclerosis Risk in Communities Study.
Publication TypeJournal Article
Year of Publication2018
AuthorsRoetker NS, Maclehose RF, Hoogeveen RC, Ballantyne CM, Basu S, Cushman M
Secondary AuthorsFolsom AR
JournalThromb Haemost
Volume118
Issue11
Pagination1940-1950
Date Published2018 Nov
ISSN2567-689X
KeywordsAtherosclerosis, Community-Based Participatory Research, Dehydroepiandrosterone Sulfate, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Postmenopause, Proportional Hazards Models, Prospective Studies, Risk, Sex Hormone-Binding Globulin, Testosterone, United States, Venous Thromboembolism
Abstract

Exogenous hormone treatments in women (oral contraceptives and hormone replacement therapy [HRT]) are established risk factors for venous thromboembolism (VTE), but less is known about associations between plasma levels of endogenous hormones and VTE risk. We examined the association of baseline dehydroepiandrosterone sulphate (DHEAS), testosterone and sex hormone-binding globulin (SHBG) with risk of future VTE in men and post-menopausal women in the Atherosclerosis Risk in Communities Study. Testosterone, DHEAS and SHBG were measured in plasma samples collected in 1996 to 1998. Cox proportional hazards models were used to estimate hazard ratios for incident VTE adjusting for age, race/ethnicity, body mass index, height, smoking, estimated glomerular filtration rate and C-reactive protein. All analyses were stratified by sex and by current HRT use in women. Among 3,051 non-HRT-using women, 1,414 HRT-using women and 3,925 men at risk at baseline, 184, 62 and 206 experienced incident VTE after a median follow-up of 17.6 years. Plasma hormones were not associated with incidence of VTE among men and non-HRT-using women, although lower plasma DHEAS, when modelled using quartiles or restricted cubic splines, was associated with higher risk of VTE among HRT-using women. This study does not support the existence of an important association between plasma concentrations of endogenous testosterone, DHEAS or SHBG with risk of VTE in middle-aged to older men or post-menopausal women not using HRT.

DOI10.1055/s-0038-1673613
Alternate JournalThromb Haemost
PubMed ID30296818
PubMed Central IDPMC6289254
Grant ListR01 HL059367 / HL / NHLBI NIH HHS / United States
HHSN268201700001I / HL / NHLBI NIH HHS / United States
HHSN268201700004I / HL / NHLBI NIH HHS / United States
HHSN268201700002I / HL / NHLBI NIH HHS / United States
HHSN268201700005I / HL / NHLBI NIH HHS / United States
R01 HL134320 / HL / NHLBI NIH HHS / United States
HHSN268201700003I / HL / NHLBI NIH HHS / United States