Table 5.
Geometric means (pmol/L) and 95% confidence intervals (CI) of serum androgens/androgen metabolites by BMI at age 18, stratified by hormone therapy use: the Women’s Health Initiative Observational Study
| Never/former hormone therapy users | Current hormone therapy users | p-intd | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BMI at age 18 | p- trenda |
%Δb | p- diffc |
BMI at age 18 | p- trenda |
%Δb | p- diffc |
||||||
| T1 | T2 | T3 | T1 | T2 | T3 | ||||||||
| Median (range) | 18.4 (8.7-19.4) | 20.2 (19.5-21.3) | 22.8 (21.4-51.5) | 18.3 (11.5-19.3) | 20.3 (19.4-20.9) | 22.1 (21.0-22.1) | |||||||
| N | 307 | 306 | 308 | 277 | 283 | 284 | |||||||
| Weighted N e | 10583 | 10136 | 9121 | 8248 | 8030 | 7731 | |||||||
| Geometric means (95% CI) | Geometric means (95% CI) | ||||||||||||
| Adrenal androgens | |||||||||||||
| DHEA | 5.30 (4.57, 6.14) | 4.47 (3.91, 5.12) | 4.52 (3.93, 5.19) | 0.005f | −14.7 | 0.06 | 4.44 (3.85, 5.13) | 3.94 (3.37, 4.61) | 3.87 (3.33, 4.51) | 0.21 | −12.8 | 0.12 | 0.68 |
| DHEAS | 1197 (1001, 1431) | 1030 (868, 1221) | 979 (837, 1144) | 0.001f | −18.2 | 0.03 | 1130 (972, 1313) | 908 (748, 1101) | 863 (720, 1034) | 0.02 | −23.6 | 0.01f | 0.83 |
| Androstenedione | 1.50 (1.36, 1.67) | 1.39 (1.24, 1.56) | 1.36 (1.22, 1.50) | 0.002f | −9.3 | 0.08 | 1.27 (1.15, 1.42) | 1.25 (1.12, 1.40) | 1.17 (1.04, 1.33) | 0.08 | −7.9 | 0.30 | 0.90 |
| Testosterone | 0.60 (0.53, 0.69) | 0.57 (0.49, 0.65) | 0.57 (0.49, 0.66) | 0.02f | −5.0 | 0.46 | 0.55 (0.49, 0.62) | 0.49 (0.43, 0.55) | 0.47 (0.41, 0.54) | 0.04 | −14.5 | 0.06 | 0.86 |
| 5α-reduced metabolites | |||||||||||||
| 5α-androstanedione | 1.27 (1.14, 1.42) | 1.28 (1.16, 1.43) | 1.35 (1.21, 1.50) | 0.39 | 6.3 | 0.39 | 1.42 (1.28, 1.58) | 1.31 (1.17, 1.46) | 1.29 (1.14, 1.45) | 0.76 | −9.2 | 0.19 | 0.72 |
| DHT | 0.18 (0.16, 0.20) | 0.18 (0.17, 0.20) | 0.19 (0.18, 0.21) | 0.89 | 5.6 | 0.26 | 0.21 (0.19, 0.23) | 0.20 (0.18, 0.23) | 0.21 (0.19, 0.24) | 0.61 | 0.0 | 0.78 | 0.49 |
| DHTS | 1.03 (0.90, 1.19) | 0.93 (0.80, 1.07) | 1.03 (0.91, 1.17) | 0.55 | 0.0 | 0.96 | 1.03 (0.88, 1.20) | 0.96 (0.81, 1.13) | 0.94 (0.81, 1.11) | 0.34 | −8.7 | 0.35 | 0.50 |
| ADT | 0.54 (0.50, 0.58) | 0.57 (0.52, 0.61) | 0.51 (0.47, 0.55) | 0.18 | −5.6 | 0.25 | 0.51 (0.47, 0.55) | 0.50 (0.46, 0.54) | 0.50 (0.46, 0.54) | 0.29 | −2.0 | 0.61 | 0.69 |
| ADT-G | 23.0 (19.4, 27.2) | 19.7 (16.6, 23.4) | 18.6 (16.0, 21.6) | 0.02f | −19.1 | 0.03 | 19.5 (16.3, 23.3) | 14.6 (12.0, 17.9) | 13.1 (10.7, 16.1) | 0.002f | −32.8 | 0.001f | 0.12 |
| 3α-diol-3G | 1.55 (1.31, 1.84) | 1.38 (1.12, 1.69) | 1.38 (1.17, 1.62) | 0.02f | −11.0 | 0.18 | 1.45 (1.25, 1.68) | 1.14 (0.96, 1.35) | 1.17 (0.99, 1.37) | 0.09 | −19.3 | 0.02 | 0.99 |
| 3α-diol-17G | 1.30 (1.12, 1.51) | 1.23 (1.06, 1.43) | 1.07 (0.94, 1.22) | 0.06 | −17.7 | 0.02 | 0.95 (0.81, 1.10) | 0.77 (0.66, 0.91) | 0.72 (0.61, 0.84) | 0.001f | −24.2 | 0.003f | 0.13 |
| Marker of tissue-level androgenic activity | |||||||||||||
| Sum of ADT-G, 3α-diol-3G, 3α-diol-17G | 26.3 (22.4, 30.9) | 22.9 (19.4, 27.0) | 21.4 (18.5, 24.7) | 0.01f | −18.6 | 0.02 | 22.2 (18.7, 26.3) | 16.9 (14.0, 20.4) | 15.5 (12.9, 18.7) | 0.002f | −30.2 | 0.002f | 0.15 |
| 5β-reduced metabolites | |||||||||||||
| Etio-G | 35.7 (29.4, 43.2) | 32.8 (27.1, 39.9) | 33.5 (28.5, 39.3) | 0.01f | −6.2 | 0.49 | 37.9 (32.7, 44.0) | 31.7 (26.6, 37.9) | 32.2 (26.9, 38.5) | 0.24 | −15.0 | 0.13 | 0.83 |
| Ratios | |||||||||||||
| DHEAS: DHEA | 226 (204, 250) | 230 (206, 257) | 217 (194, 242) | 0.12 | −4.0 | 0.51 | 254 (228, 283) | 231 (204, 261) | 223 (197, 252) | 0.09 | −12.2 | 0.07 | 0.41 |
| DHTS: DHT | 5.75 (4.92, 6.72) | 5.07 (4.31, 5.97) | 5.31 (4.56, 6.19) | 0.71 | −7.7 | 0.41 | 4.93 (4.16, 5.84) | 4.69 (4.00, 5.50) | 4.46 (3.76, 5.28) | 0.24 | −9.5 | 0.29 | 0.31 |
| DHT: Testosterone | 0.30 (0.26, 0.34) | 0.32 (0.28, 0.38) | 0.34 (0.29, 0.39) | 0.07 | 13.3 | 0.07 | 0.38 (0.33, 0.43) | 0.42 (0.37, 0.48) | 0.45 (0.39, 0.52) | 0.01f | 18.4 | 0.04 | 0.49 |
| Unconjugated estrone: Androstenedione | 42.5 (36.4, 49.6) | 41.9 (36.7, 47.7) | 46.1 (40.0, 53.0) | 0.29 | 8.5 | 0.33 | 172 (140, 211) | 186 (153, 226) | 221 (180, 272) | 0.03 | 28.5 | 0.06 | 0.88 |
| Unconjugated estradiol: Testosterone | 25.1 (20.6, 30.7) | 26.5 (21.7, 32.5) | 23.6 (19.2, 29.0) | 0.99 | −6.0 | 0.58 | 81.2 (64.4, 102) | 90.5 (72.5, 113) | 114 (89.5, 145) | 0.15 | 40.4 | 0.02 | 0.42 |
Adjusted for age at blood draw (<55, 55–59, 60–64, 65–69, 70–74, 75–79 years), calendar year at blood draw (1993–1996, 1997–1998), race (White, non-White), smoking status (never, former, current), alcohol drinking (non-drinker, <1 drink/week, 1-6 drink/week, ≥7 drink/week), parous (yes, no), family history of breast and ovarian cancer (yes, no), time since menopause (<10 years, 10–19 years, ≥20 years, missing), moderate- to vigorous-intensity physical activity (0, 0.1–9.9, ≥10 metabolic equivalents of task-h/week), and current BMI (kg/m2, continuous). Additionally adjusted for hormone therapy use (never, former) among women not using hormone therapy use.
p-trend was estimated using the Wald test for continuous BMI at age 18 (kg/m2)
%Δ indicates the percentage change in GMs of androgens/androgen metabolite levels, comparing women at the highest vs. lowest tertiles of BMI at age 18.
p-diff was estimated using the Wald test and indicates a p-value for comparing androgens/androgen metabolite levels of women at the highest vs. lowest tertiles of BMI at age 18.
p-int was estimated using the Wald test for an interaction term between BMI at age 18 and hormone therapy use.
Weighted n reflects weighted counts and refers to the study cohort.
False discovery rate (FDR) q value <0.05 and ≥0.01