Cardiovascular fat, menopause, and sex hormones in women: The SWAN cardiovascular fat ancillary study

Samar R. El Khoudary, Kelly J. Shields, Imke Janssen, Carrie Hanley, Matthew J. Budoff, Emma Barinas-Mitchell, Susan A. Everson-Rose, Lynda H. Powell, Karen A. Matthews

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Context: Cardiovascular risk increases in women after menopause. Mounting evidence demonstrates a role of cardiovascular fat (CF) in the pathogenesis of coronary heart disease, but no research has examined CF in relation to sex hormones or menopausal status in women. Objective: The objective was to determine the relationship between CF depots, menopausal status, and endogenous sex hormones. Design: Cross-sectional and longitudinal study designs were used. Setting: The setting included the Study of Women's Health Across the Nation (SWAN) Heart and Cardiovascular Fat Ancillary Study. Participants: A total of 456 women (mean age, 50.75 y); 62% premenopausal/early perimenopausal, and 38% late peri-/postmenopausal. Intervention: Menopausal status, endogenous sex hormones measured simultaneously with CF volumes, and circulating estradiol available 4.80 years (median) before CF measures. MainOutcomeMeasures: Volumes of CF (epicardial adipose tissue [EAT], paracardial adipose tissue [PAT], total heart adipose tissue [TAT=EAT=PAT], and aortic perivascular adipose tissue [PVAT]). Results: In final models, late peri-/postmenopausal women had 9.88% more EAT, 20.72% more PAT, and 11.69% more TAT volumes than pre-/early perimenopausal women (P < .05). PVAT was not associated with menopausal status. In final models, lower estradiol concentrations were associated with greater volumes of PAT and TAT (P < .05). Women with the greatest reduction in estradiol since baseline had greater volumes of PAT compared to women with the least reduction (P = .02). Conclusions: Late peri-/postmenopausal women have greater volumes of heart fat compared with pre-/early perimenopausalwomenindependent of age, obesity, and other covariates. Endogenous sex hormones are associated with CF. Perhaps CF plays a role in the higher risk of coronary heart disease reported in women after menopause.

Original languageEnglish (US)
Pages (from-to)3304-3312
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume100
Issue number9
DOIs
StatePublished - Sep 1 2015

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    El Khoudary, S. R., Shields, K. J., Janssen, I., Hanley, C., Budoff, M. J., Barinas-Mitchell, E., Everson-Rose, S. A., Powell, L. H., & Matthews, K. A. (2015). Cardiovascular fat, menopause, and sex hormones in women: The SWAN cardiovascular fat ancillary study. Journal of Clinical Endocrinology and Metabolism, 100(9), 3304-3312. https://doi.org/10.1210/JC.2015-2110