Association Between Statin Use and Sex Hormone in the Multi-Ethnic Study of Atherosclerosis Cohort

Author:

Oluleye Oludamilola W1ORCID,Kronmal Richard A2,Folsom Aaron R3,Vaidya Dhananjay M4,Ouyang Pamela4,Duprez Daniel A5,Dobs Adrian S4,Yarmohammadi Hirad6,Konety Suma H5

Affiliation:

1. Essentia Health-Fargo Heart and Vascular Center, Fargo, North Dakota

2. Department of Biostatistics, University of Washington, Seattle, Washington

3. Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota

4. Johns Hopkins University School of Medicine, Baltimore, Maryland

5. Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, Minnesota

6. Columbia University, New York, New York

Abstract

Abstract Purpose Based on the 2018 American College of Cardiology/American Heart Association cholesterol guidelines, the number of individuals eligible for statin therapy to reduce atherosclerotic cardiovascular disease risk has greatly expanded. Statins inhibit cholesterol biosynthesis, which can impair gonadal steroidogenesis. We evaluated the effect of statins on endogenous sex hormones in a large epidemiological study. Methods A total of 6814 Multi-Ethnic Study of Atherosclerosis (MESA) participants underwent the baseline examination. Of these, 6171 had measurements of serum sex hormones available: dehydroepiandrosterone (DHEA), SHBG, estradiol, and total and bioavailable testosterone. Multivariable linear regression models were used to assess the relationship of statin use with each sex hormone. Results A total of 345 women (17.4%) and 464 men (14.7%) were statin users (mean age, 67 years; 41% white, 29% black, 11% Chinese, and 19% Hispanic). Among the users vs nonusers of statins, the mean SHBG was 3.54 nmol/L (P < 0.01) lower in women and 3.37 nmol/L (P < 0.001) lower in men; the mean DHEA was 1.06 nmol/L (P < 0.05) lower in women and 0.70 nmol/L (P < 0.01) lower in men, after adjustment for potential confounders. With further propensity score adjustment, the mean DHEA and SHBG levels were 0.67 nmol/L (P < 0.05) and 3.49 nmol/L (P < 0.001) lower, respectively, for statin users vs nonusers. No statistically significant association was noted between estradiol, total testosterone, and bioavailable testosterone and statin use. Conclusion Statin users have lower levels of SHBG and DHEA. This is especially relevant owing to the increasing use of statin therapy.

Funder

National Heart, Lung, and Blood Institute

Publisher

The Endocrine Society

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

Reference31 articles.

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2. Statins: new American guidelines for prevention of cardiovascular disease;Ridker;Lancet,2013

3. Comment on the reports of over-estimation of ASCVD risk using the 2013 AHA/ACC risk equation;Muntner;Circulation,2014

4. Majority of panelists on controversial new cholesterol guideline have current or recent ties to drug manufacturers;Lenzer;BMJ,2013

5. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines;Goff;J Am Coll Cardiol,2014

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