Endogenous oestradiol as a positive correlate of plasma fibrinogen among older postmenopausal women: a population-based study (the Three-City cohort study)

Authors

  • Marianne Canonico,

    Corresponding author
    • Centre for Research in Epidemiology and Population Health, U1018, Hormones and Cardiovascular Disease and Univ Paris-Sud, UMR-S 1018, Villejuif, France
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  • Sylvie Brailly-Tabard,

    1. Service de Génétique moléculaire, Pharmacogénétique et Hormonologie, Hôpital Bicêtre, APHP, Le Kremlin-Bicêtre, France
    2. Inserm UMR-S693, Univ Paris-sud, IFR Bicêtre, Le Kremlin-Bicêtre, France
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  • Pascale Gaussem,

    1. Inserm U765, Université Paris Descartes, Sorbonne Paris Cité, APHP, Hôpital Européen Georges Pompidou, Paris, France
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  • Julie Setiao,

    1. Service de Génétique moléculaire, Pharmacogénétique et Hormonologie, Hôpital Bicêtre, APHP, Le Kremlin-Bicêtre, France
    2. Inserm UMR-S693, Univ Paris-sud, IFR Bicêtre, Le Kremlin-Bicêtre, France
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  • Olivier Rouaud,

    1. CMMR CHU Dijon, Dijon, France
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  • Joanne Ryan,

    1. Inserm Unit 1061, University Montpellier, Montpellier, France
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  • Laure Carcaillon,

    1. Centre for Research in Epidemiology and Population Health, U1018, Hormones and Cardiovascular Disease and Univ Paris-Sud, UMR-S 1018, Villejuif, France
    2. Inserm Unit U593, Victor Segalen University, Bordeaux, France
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  • Anne Guiochon-Mantel,

    1. Service de Génétique moléculaire, Pharmacogénétique et Hormonologie, Hôpital Bicêtre, APHP, Le Kremlin-Bicêtre, France
    2. Inserm UMR-S693, Univ Paris-sud, IFR Bicêtre, Le Kremlin-Bicêtre, France
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  • Pierre-Yves Scarabin

    1. Centre for Research in Epidemiology and Population Health, U1018, Hormones and Cardiovascular Disease and Univ Paris-Sud, UMR-S 1018, Villejuif, France
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Correspondence: Marianne Canonico, Centre for Research in Epidemiology and Population Health, U1018, Hormones and Cardiovascular Disease and Univ Paris-Sud, UMR-S 1018, 16 av. Paul Vaillant Couturier, 94807 Villejuif Cedex, France. Tel.: +33 1 45 59 51 66; Fax: +33 1 45 59 51 70; E-mail: marianne.canonico@inserm.fr

Summary

Background

Plasma fibrinogen is a strong predictor of ischaemic arterial disease in women. Sex steroid hormones including hormone therapy may play an important role in the development of cardiovascular disease. However, whether endogenous sex steroid hormones influence the plasma fibrinogen concentrations among postmenopausal women remains unclear.

Objectives

To investigate the association of plasma fibrinogen levels with endogenous sex steroid hormones and sex hormone binding globulin (SHBG) among postmenopausal women.

Methods

We used data from the French prospective Three-City cohort study that included 9294 noninstitutionalized men and women over 65 years of age. Total 17β-oestradiol (E2, pg/ml), total testosterone (T, ng/ml), SHBG (nm) and fibrinogen (g/l) were measured in stored plasmas in a subcohort of 602 randomly selected postmenopausal women who used neither hormone medication nor anticoagulation therapy. Multivariate linear regression models were used to estimate the regression coefficients assessed in fibrinogen unit by 1 SD increase in log-distribution of sex steroid hormones and SHBG.

Results

E2 but neither T nor SHBG was positively associated with plasma fibrinogen levels (β = 0·148, P < 0·001). Adjustment for cardiovascular risk factors including diabetes made no substantial change to the results (β = 0·145, P < 0·001). The association of fibrinogen with E2 was stronger among women with body mass index over 25 kg/m2 compared with those with normal weight (β = 0·156, P < 0·001 and β = 0·092, P = 0·02, respectively, P for interaction = 0·04).

Conclusion

E2 emerges as a positive and independent correlate of plasma fibrinogen among postmenopausal women, especially in subjects who are overweight. These findings suggest a deleterious effect of endogenous oestrogens on cardiovascular risk profile among postmenopausal women.

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