title: Trajectories of estradiol and follicle-stimulating hormone over the menopause transition and early markers of atherosclerosis after menopause.
abstract: OBJECTIVE
  The purpose of this study was to assess associations between distinct patterns of circulating estradiol (E2) and follicle-stimulating hormone (FSH) over the menopause transition (MT) and subclinical measures of atherosclerosis after menopause.
  
  
  RESULTS
  Four temporal patterns of E2 decline (Low: low before and after final menstrual period (FMP); Medium: medium before and high after FMP; High-early decline: high prior to FMP and early decline thereafter; High-late decline: high prior to FMP and late decline thereafter) and three of FSH rise (Low, Medium, High) over 9.6 years across FMP were identified and linked to carotid intima-media-thickness (IMT), adventitial diameter (AD), and presence of carotid plaque (cPlaque) measured after menopause at the 12th annual visit (visit 12). Participants were 856 women (age at visit 12 = 59.5 ± 2.7 years) from the Study of Women's Health Across the Nation (SWAN), who never reported a stroke or a heart attack. In models adjusted for visit 12 or baseline cardiovascular disease (CVD) risk factors, odds of having any cPlaque were ∼43% lower among women with the High-early decline E2 trajectory compared to women with the Low E2 trajectory. In contrast, women with the Medium E2 trajectory had significantly higher IMT than those with the Low E2 trajectory adjusting for visit 12 CVD risk factors. Interestingly, adjusting for baseline CVD risk factors attenuated this association. The Low FSH group had lower IMT than the Medium and High FSH groups (p ≤ 0.05) in all models.
  
  
  CONCLUSIONS
  During MT, women are subjected to hormonal alterations that could potentially increase their risk of developing CVD after menopause.
authors.affiliation: Department of Epidemiology, University of Pittsburgh, USA elkhoudarys@edc.pitt.edu.
authors.forename: Samar R
authors.initials: SR
authors.lastname: El Khoudary
authors.affiliation: School of Medicine, University of Colorado, USA.
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
authors.affiliation: Department of Epidemiology, University of Pittsburgh, USA.
authors.forename: Hsiang-Yu
authors.initials: HY
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, University of Pittsburgh, USA.
authors.forename: Ping G
authors.initials: PG
authors.lastname: Tepper
authors.affiliation: Department of Epidemiology, University of Pittsburgh, USA.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Brooks
authors.affiliation: Department of Epidemiology, University of Pittsburgh, USA Department of Psychiatry, University of Pittsburgh, USA.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Thurston
authors.affiliation: Rush University Medical Center, USA.
authors.forename: Imke
authors.initials: I
authors.lastname: Janssen
authors.affiliation: Department of Epidemiology University of Michigan, USA.
authors.forename: Sioban D
authors.initials: SD
authors.lastname: Harlow
authors.affiliation: Department of Epidemiology, University of Pittsburgh, USA.
authors.forename: Emma
authors.initials: E
authors.lastname: Barinas-Mitchell
authors.affiliation: Department of Epidemiology, University of Pittsburgh, USA.
authors.forename: Faith
authors.initials: F
authors.lastname: Selzer
authors.affiliation: Department of Neurology and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, USA.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Derby
authors.affiliation: Department of Internal Medicine, University of Michigan Medical School, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jackson
authors.affiliation: Department of Epidemiology University of Michigan, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: McConnell
authors.affiliation: Department of Epidemiology, University of Pittsburgh, USA Department of Psychiatry, University of Pittsburgh, USA.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
mesh_terms: D000328:Adult; D000375:Aging / Q000097:blood / Q000208:ethnology*; D001213:Asian; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis / Q000208:ethnology*; D015415:Biomarkers / Q000097:blood; D059168:Carotid Intima-Media Thickness; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D005500:Follow-Up Studies; D006630:Hispanic or Latino; D006801:Humans; D008593:Menopause / Q000097:blood / Q000208:ethnology*; D008875:Middle Aged; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People
chemical_list: D015415:Biomarkers; D005640:Follicle Stimulating Hormone
keywords: Estradiol; atherosclerosis; epidemiology; intima-media thickness; menopause; women