Abstract Background Emerging evidence suggests that fluctuations in female sex hormones (Luteinizing hormone (LH), Progesterone(P), Estrogen(E2), Prolactin (PRL), Testosterone(T) , and Follicle-Stimulating Hormone (FSH)) may directly modulate endothelial function, lipid metabolism, and systemic inflammation, the key pathways in CVD pathogenesis. However, comprehensive analyses of the six female sex hormones on CVD incidence remain sparse. Purpose This study was aimed to systematically evaluate the with between six female sex hormones of incident CVD, with the aim of refining sex-specific risk prediction. Methods We included female participants aged ≥18 years, with at least one measurement of female sex hormones (LH,P,E2,T,PRL,FSH) between 1 January 2011, and 5 March 2021 from the CHinese Electronic Health Records Research in Yinzhou (CHERRY) study, an electronic health record-based cohort study. The measurements of the six hormones were extracted from the prenatal and obstetric records within the CHERRY, and we categorized them into quintiles based on baseline measurements for analysis. The outcome of CVD in the current study was defined as a composite of coronary heart disease(ICD-10 code: I21-I25), stroke(I60-I69), and heart failure(I50). Cox proportional hazards models were employed to estimate the hazard ratios (HR) and 95% confidence interval (CI) of association between quintiles of six hormones and CVD. Subgroup analyses stratified by menopausal status were conducted to examine potential heterogeneity in the associations between hormones and CVD risk. Results Compared to the middle quintile of LH, both the lowest (HR: 1.52, 95%CI: 1.15-2.02,p=0.004) and the highest quintile (HR:1.41, 95%CI: 1.08-1.84,p=0.012) were associated with higher risk of CVD. The results of the subgroup analysis stratified by menopausal status were consistent with the primary analysis (p for interaction=0.045). Compared to the middle quintile of P, the highest quintile group (HR=0.71,95%CI :0.53-0.94, p=0.019) was significantly associated with a reduced risk. Compared to the fourth quintile of E2, the highest quintile group (HR=0.69,95%CI:0.51-0.92, p=0.013) was significantly associated with a reduced risk. In the PRL cohort, elevated the fourth quintile was associated with a 32% (1%-72%) higher cardiovascular risk. Compared to the fourth quintile of T, the lowest quintile group (HR=1.33,95%CI:1.01-1.75,p=0.043) and the middle quintile of T (HR=1.42, 95% CI:1.06-1.90, p=0.02) had elevated risks. We did not observe significant associations for FSH and CVD. Conclusions In female adults, both lowest and highest LH levels were associated with a higher risk of cardiovascular disease. Similarly, higher T levels were related to an increased risk, while higher levels of E2 and P were related to a lower risk. This study provides a scientific supplementary reference for the primary prevention of cardiovascular diseases in women.HR for Incident CVD by Hormone Levels
Wang et al. (Sat,) studied this question.