The Role of Follicle-stimulating Hormone in Vascular Dysfunction Observed in Hematopoietic Cell Transplant Recipients

Childhood cancer survivors who receive a hematopoietic cell transplantation HCT are at increased risk for follicle-stimulating hormone FSH abnormalities, which may have a substantial negative impact on vascular function. The purpose of this study was to examine the association of vascular function with FSH in HCT recipients, non-HCT recipients and healthy controls. The study included childhood cancer survivors who were HCT recipients n=24 and non-HCT recipients n=308, and a control group of healthy siblings n=211 all between 9 and 18 years old. Vascular measures of carotid artery structure and function compliance and distensibility, brachial artery flow-mediated dilation and endothelial-independent dilation were measured using ultrasound imaging. A fasting blood sample was collected to measure hormone levels. FSH was significantly higher in HCT recipients compared with non-HCT recipients and healthy controls P<0.01. Carotid compliance and distensibility were significantly lower in HCT and non-HCT recipients compared with healthy controls P<0.05. Higher FSH was associated with decreased carotid compliance P<0.05. This study's results suggest that higher levels of FSH in HCT recipients may result in significant reductions in vascular function compared with non-HCT recipients and healthy controls. Therefore, gonadotropin endocrine dysfunction, particularly abnormal FSH levels, may be an underlying mechanism of vascular dysfunction.