title: Cardiovascular Fat, Menopause, and Sex Hormones in Women: The SWAN Cardiovascular Fat Ancillary Study.
abstract: BACKGROUND
  Cardiovascular risk increases in women after menopause. Mounting evidence demonstrates a role of cardiovascular fat (CF) in the pathogenesis of coronary heart disease, but no research has examined CF in relation to sex hormones or menopausal status in women.
  
  
  OBJECTIVE
  The objective was to determine the relationship between CF depots, menopausal status, and endogenous sex hormones.
  
  
  METHODS
  Cross-sectional and longitudinal study designs were used.
  
  
  METHODS
  The setting included the Study of Women's Health Across the Nation (SWAN) Heart and Cardiovascular Fat Ancillary Study.
  
  
  METHODS
  A total of 456 women (mean age, 50.75 y); 62% premenopausal/early perimenopausal, and 38% late peri-/postmenopausal.
  
  
  METHODS
  Menopausal status, endogenous sex hormones measured simultaneously with CF volumes, and circulating estradiol available 4.80 years (median) before CF measures.
  
  
  METHODS
  Volumes of CF (epicardial adipose tissue [EAT], paracardial adipose tissue [PAT], total heart adipose tissue [TAT = EAT + PAT], and aortic perivascular adipose tissue [PVAT]).
  
  
  RESULTS
  In final models, late peri-/postmenopausal women had 9.88% more EAT, 20.72% more PAT, and 11.69% more TAT volumes than pre-/early perimenopausal women (P < .05). PVAT was not associated with menopausal status. In final models, lower estradiol concentrations were associated with greater volumes of PAT and TAT (P < .05). Women with the greatest reduction in estradiol since baseline had greater volumes of PAT compared to women with the least reduction (P = .02).
  
  
  CONCLUSIONS
  Late peri-/postmenopausal women have greater volumes of heart fat compared with pre-/early perimenopausal women independent of age, obesity, and other covariates. Endogenous sex hormones are associated with CF. Perhaps CF plays a role in the higher risk of coronary heart disease reported in women after menopause.
authors.affiliation: University of Pittsburgh Graduate School of Public Health (S.R.E.K., C.H., E.B.-M., K.A.M.), Department of Epidemiology, Pittsburgh, Pennsylvania 15261; Lupus Center of Excellence (K.J.S.), Department of Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania 15212; Rush University Medical Center (I.J., L.H.P.), Department of Preventive Medicine, Chicago, Illinois 60612; Los Angeles Biomedical Research Institute (M.J.B.), Division of Cardiology, Torrance, California 90502; Department of Medicine, Program in Health Disparities Research and Center for Health Equity (S.A.E.-R.), University of Minnesota, Minneapolis, Minnesota 55414; and University of Pittsburgh School of Medicine (K.A.M.), Department of Psychiatry, Pittsburgh, Pennsylvania 15213.
authors.forename: Samar R
authors.initials: SR
authors.lastname: El Khoudary
authors.affiliation: University of Pittsburgh Graduate School of Public Health (S.R.E.K., C.H., E.B.-M., K.A.M.), Department of Epidemiology, Pittsburgh, Pennsylvania 15261; Lupus Center of Excellence (K.J.S.), Department of Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania 15212; Rush University Medical Center (I.J., L.H.P.), Department of Preventive Medicine, Chicago, Illinois 60612; Los Angeles Biomedical Research Institute (M.J.B.), Division of Cardiology, Torrance, California 90502; Department of Medicine, Program in Health Disparities Research and Center for Health Equity (S.A.E.-R.), University of Minnesota, Minneapolis, Minnesota 55414; and University of Pittsburgh School of Medicine (K.A.M.), Department of Psychiatry, Pittsburgh, Pennsylvania 15213.
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Shields
authors.affiliation: University of Pittsburgh Graduate School of Public Health (S.R.E.K., C.H., E.B.-M., K.A.M.), Department of Epidemiology, Pittsburgh, Pennsylvania 15261; Lupus Center of Excellence (K.J.S.), Department of Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania 15212; Rush University Medical Center (I.J., L.H.P.), Department of Preventive Medicine, Chicago, Illinois 60612; Los Angeles Biomedical Research Institute (M.J.B.), Division of Cardiology, Torrance, California 90502; Department of Medicine, Program in Health Disparities Research and Center for Health Equity (S.A.E.-R.), University of Minnesota, Minneapolis, Minnesota 55414; and University of Pittsburgh School of Medicine (K.A.M.), Department of Psychiatry, Pittsburgh, Pennsylvania 15213.
authors.forename: Imke
authors.initials: I
authors.lastname: Janssen
authors.affiliation: University of Pittsburgh Graduate School of Public Health (S.R.E.K., C.H., E.B.-M., K.A.M.), Department of Epidemiology, Pittsburgh, Pennsylvania 15261; Lupus Center of Excellence (K.J.S.), Department of Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania 15212; Rush University Medical Center (I.J., L.H.P.), Department of Preventive Medicine, Chicago, Illinois 60612; Los Angeles Biomedical Research Institute (M.J.B.), Division of Cardiology, Torrance, California 90502; Department of Medicine, Program in Health Disparities Research and Center for Health Equity (S.A.E.-R.), University of Minnesota, Minneapolis, Minnesota 55414; and University of Pittsburgh School of Medicine (K.A.M.), Department of Psychiatry, Pittsburgh, Pennsylvania 15213.
authors.forename: Carrie
authors.initials: C
authors.lastname: Hanley
authors.affiliation: University of Pittsburgh Graduate School of Public Health (S.R.E.K., C.H., E.B.-M., K.A.M.), Department of Epidemiology, Pittsburgh, Pennsylvania 15261; Lupus Center of Excellence (K.J.S.), Department of Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania 15212; Rush University Medical Center (I.J., L.H.P.), Department of Preventive Medicine, Chicago, Illinois 60612; Los Angeles Biomedical Research Institute (M.J.B.), Division of Cardiology, Torrance, California 90502; Department of Medicine, Program in Health Disparities Research and Center for Health Equity (S.A.E.-R.), University of Minnesota, Minneapolis, Minnesota 55414; and University of Pittsburgh School of Medicine (K.A.M.), Department of Psychiatry, Pittsburgh, Pennsylvania 15213.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
authors.affiliation: University of Pittsburgh Graduate School of Public Health (S.R.E.K., C.H., E.B.-M., K.A.M.), Department of Epidemiology, Pittsburgh, Pennsylvania 15261; Lupus Center of Excellence (K.J.S.), Department of Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania 15212; Rush University Medical Center (I.J., L.H.P.), Department of Preventive Medicine, Chicago, Illinois 60612; Los Angeles Biomedical Research Institute (M.J.B.), Division of Cardiology, Torrance, California 90502; Department of Medicine, Program in Health Disparities Research and Center for Health Equity (S.A.E.-R.), University of Minnesota, Minneapolis, Minnesota 55414; and University of Pittsburgh School of Medicine (K.A.M.), Department of Psychiatry, Pittsburgh, Pennsylvania 15213.
authors.forename: Emma
authors.initials: E
authors.lastname: Barinas-Mitchell
authors.affiliation: University of Pittsburgh Graduate School of Public Health (S.R.E.K., C.H., E.B.-M., K.A.M.), Department of Epidemiology, Pittsburgh, Pennsylvania 15261; Lupus Center of Excellence (K.J.S.), Department of Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania 15212; Rush University Medical Center (I.J., L.H.P.), Department of Preventive Medicine, Chicago, Illinois 60612; Los Angeles Biomedical Research Institute (M.J.B.), Division of Cardiology, Torrance, California 90502; Department of Medicine, Program in Health Disparities Research and Center for Health Equity (S.A.E.-R.), University of Minnesota, Minneapolis, Minnesota 55414; and University of Pittsburgh School of Medicine (K.A.M.), Department of Psychiatry, Pittsburgh, Pennsylvania 15213.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Everson-Rose
authors.affiliation: University of Pittsburgh Graduate School of Public Health (S.R.E.K., C.H., E.B.-M., K.A.M.), Department of Epidemiology, Pittsburgh, Pennsylvania 15261; Lupus Center of Excellence (K.J.S.), Department of Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania 15212; Rush University Medical Center (I.J., L.H.P.), Department of Preventive Medicine, Chicago, Illinois 60612; Los Angeles Biomedical Research Institute (M.J.B.), Division of Cardiology, Torrance, California 90502; Department of Medicine, Program in Health Disparities Research and Center for Health Equity (S.A.E.-R.), University of Minnesota, Minneapolis, Minnesota 55414; and University of Pittsburgh School of Medicine (K.A.M.), Department of Psychiatry, Pittsburgh, Pennsylvania 15213.
authors.forename: Lynda H
authors.initials: LH
authors.lastname: Powell
authors.affiliation: University of Pittsburgh Graduate School of Public Health (S.R.E.K., C.H., E.B.-M., K.A.M.), Department of Epidemiology, Pittsburgh, Pennsylvania 15261; Lupus Center of Excellence (K.J.S.), Department of Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania 15212; Rush University Medical Center (I.J., L.H.P.), Department of Preventive Medicine, Chicago, Illinois 60612; Los Angeles Biomedical Research Institute (M.J.B.), Division of Cardiology, Torrance, California 90502; Department of Medicine, Program in Health Disparities Research and Center for Health Equity (S.A.E.-R.), University of Minnesota, Minneapolis, Minnesota 55414; and University of Pittsburgh School of Medicine (K.A.M.), Department of Psychiatry, Pittsburgh, Pennsylvania 15213.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D050154:Adiposity / Q000502:physiology*; D000328:Adult; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D008137:Longitudinal Studies; D008593:Menopause / Q000097:blood / Q000502:physiology*; D008875:Middle Aged; D011859:Radiography; D012307:Risk Factors; D013739:Testosterone / Q000097:blood*
chemical_list: D013739:Testosterone; D004958:Estradiol; D005640:Follicle Stimulating Hormone