Table 2:
Associations between serum concentrations of sex steroids and SHBG and risk of MACE and all-cause mortality
| Median blood concentration (IDR) | Number of samples | MACE (n=144) |
All-cause mortality (n=200) |
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|---|---|---|---|---|---|---|---|---|---|---|
| Unadjusted analysis |
Adjusted analysis |
Unadjusted analysis |
Adjusted analysis |
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| HR (95% CI) | p value* | HR (95% CI) | p value† | HR (95% CI) | p value* | HR (95% CI) | p value† | |||
| Oestrone | ||||||||||
|
| ||||||||||
| Quartile 1 | 96·2 pmol/L (48·1–122·1)‡ | 1405 (25·4%) | 1 (ref) | ·· | 1 (ref) | ·· | 1 (ref) | ·· | 1 (ref) | ·· |
| Quartile 2 | 155·3 pmol/L (133·1–177·5)‡ | 1425 (25·7%) | 0·62 (0·38–1·02) | 0·061 | 0·55 (0·33–0·92) | 0·022 | 1·27 (0·83–1·93) | 0·27 | 1·28 (0·84–1·96) | 0·26 |
| Quartile 3 | 218·2 pmol/L (188·6–258·9)‡ | 1426 (25·8%) | 1·01 (0·68–1·60) | 0·86 | 0·92 (0·60–1·43) | 0·72 | 1·30 (0·86–1·98) | 0·21 | 1·25 (0·82–1·91) | 0·30 |
| Quartile 4 | 336·6 pmol/L (284·8–484·5)‡ | 1279 (23·1%) | 0·91 (0·58–1·44) | 0·70 | 0·69 (0·43–1·11) | 0·12 | 1·46 (0·96–2·21) | 0·074 | 1·31 (0·85–2·01) | 0·22 |
|
| ||||||||||
| Testosterone | ||||||||||
|
| ||||||||||
| Quartile 1 | 0·17 nmol/L (0·10–0·24)§ | 1641 (29·6%) | 1 (ref) | ·· | 1 (ref) | ·· | 1 (ref) | ·· | 1 (ref) | ·· |
| Quartile 2 | 0·31 nmol/L (0·28–0·35)§ | 1104 (20·0%) | 0·70 (0·44–1·12) | 0·13 | 0·67 (0·42–1·07) | 0·094 | 0·90 (0·60–1·36) | 0·62 | 0·87 (0·56–1·29) | 0·44 |
| Quartile 3 | 0·45 nmol/L (0·38–0·55)§ | 1497 (27·0%) | 0·66 (0·43–1·01) | 0·06 | 0·64 (0·41–0·99) | 0·045 | 1·02 (0·71–1·47) | 0·92 | 1·02 (0·70–1·47) | 0·93 |
| Quartile 4 | 0·79 nmol/L (0·59–1·98)§ | 1293 (23·4%) | 0·65 (0·42–1·02) | 0·064 | 0·57 (0·36–0·91) | 0·018 | 0·94 (0·64–1·39) | 0·77 | 0·83 (0·56–1·23) | 0·36 |
|
| ||||||||||
| DHEA | ||||||||||
|
| ||||||||||
| Quartile 1 | 1·11 nmol/L (0·52–1·53)¶ | 1307 (23·6%) | 1 (ref) | ·· | 1 (ref) | ·· | 1 (ref) | ·· | 1 (ref) | ·· |
| Quartile 2 | 2·08 nmol/L (1·70–2·46)¶ | 1420 (25·7%) | 0·57 (0·37–0·89) | 0·012 | 0·60 (0·38–0·94) | 0·026 | 1·11 (0·76–1·62) | 0·58 | 1·35 (0·92–1·98) | 0·13 |
| Quartile 3 | 3·19 nmol/L (2·70–3·81)¶ | 1422 (25·7%) | 0·49 (0·31–0·78) | 0·002 | 0·57 (0·36–0·90) | 0·017 | 0·73 (0·48–1·10) | 0·14 | 0·93 (0·61–1·42) | 0·73 |
| Quartile 4 | 5·58 nmol/L (4·19–8·60)¶ | 1386 (25·0%) | 0·52 (0·33–0·81) | 0·004 | 0·61 (0·38–0·97) | 0·037 | 0·78 (0.52–1·18) | 0·24 | 1·08 (0·71–1·64) | 0·72 |
|
| ||||||||||
| SHBG | ||||||||||
|
| ||||||||||
| Quartile 1 | 25·10 nmol/L (17·70–29·80) | 1383 (25·0%) | 1 (ref) | ·· | 1 (ref) | ·· | 1 (ref) | ·· | 1 (ref) | ·· |
| Quartile 2 | 36·20 nmol/L (32·00–40·60) | 1423 (25·8%) | 0·92 (0·58–1·46) | 0·73 | 0·82 (0·51–1·33) | 0·43 | 1·09 (0·72–1·67) | 0·67 | 0·98 (0·63–1·51) | 0·92 |
| Quartile 3 | 47·40 nmol/L (42·60–53·20) | 1409 (25·5%) | 0.96 (0·61–1·52) | 0·87 | 0·85 (0·52–1·38) | 0·52 | 1·09 (0·71–1·66) | 0·70 | 0·88 (0·56–1·37) | 0·57 |
| Quartile 4 | 65·80 nmol/L (56·80–91·20) | 1309 (23·7%) | 1·05 (0·66–1·66) | 0·83 | 0·89 (0·54–1·48) | 0·65 | 1·76 (1·19–2·60) | 0·004 | 1·32 (1·10–2·04) | 0·20 |
SHBG=sex hormone-binding globulin. MACE=major adverse cardiovascular events. IDR=interdecile range. HR=hazard ratio. DHEA=dehydroepiandrosterone.
Separate univariable models fitted for each sex steroid.
Models for each hormone were all adjusted for age, body-mass index, smoking status, alcohol consumption, diabetes, dyslipidaemia, hypertension, impaired renal function, and treatment allocation (aspirin vs placebo). Quartiles did not include exactly 25% of the observations for each hormone because for some hormones, especially oestrone and testosterone, many women shared the same value.
To convert to pg/mL, divide by 3·699.
To convert to ng/dL, divide by 0·0347.
To convert to mg/L, divide by 3·467.