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

Nicholas S. Roetker; Richard F. MacLehose; Ron C. Hoogeveen; Christie M. Ballantyne; Saonli Basu; Mary Cushman; Aaron R. Folsom

doi:10.1055/s-0038-1673613

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2018; 118(11): 1940-1950
DOI: 10.1055/s-0038-1673613

Stroke, Systemic or Venous Thromboembolism

Georg Thieme Verlag KG Stuttgart · New York

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

Nicholas S. Roetker

¹Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, Minnesota, United States

²Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States

,

Richard F. MacLehose

²Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States

,

Ron C. Hoogeveen

³Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, The Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, Texas, United States

,

Christie M. Ballantyne

³Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, The Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, Texas, United States

,

Saonli Basu

⁴Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States

,

Mary Cushman

⁵Division of Hematology/Oncology, Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, United States

,

Aaron R. Folsom

²Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States

› Author Affiliations

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.

Keywords

deep vein thrombosis - pulmonary embolism - epidemiologic studies - risk factors - hormones

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References

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Supplementary Material