title: Genetically predicted 17beta-estradiol and cardiovascular risk factors in women: a Mendelian randomization analysis using young women in Hong Kong and older women in the Guangzhou Biobank Cohort Study.
abstract: OBJECTIVE
  The role of estrogen in cardiovascular health remains contested with discrepancies between findings from randomized controlled trials and observational studies. Mendelian randomization, which assesses the effect of lifelong endogenous exposure, may help elucidate these discrepancies.
  
  
  METHODS
  We used separate sample instrumental variable analysis to estimate the association of log 17β-estradiol with factors related to cardiovascular disease risk (systolic and diastolic blood pressure, lipids, fasting glucose, body mass index, waist hip ratio, and waist circumference) and Framingham score, a predictor of 10-year risk of ischemic heart disease events, in older Chinese women from the Guangzhou Biobank Cohort Study (GBCS, n = 3092). The estimate was derived using the Wald estimator, that is, the ratio of the association of genetic determinants (rs1008805 and rs2175898) of log 17β-estradiol with cardiovascular disease risk factors and Framingham score in GBCS and the association of these genetic determinants with log 17β-estradiol in a sample of young women from Hong Kong (n = 236).
  
  
  RESULTS
  Genetically, higher 17β-estradiol was not associated with any cardiovascular disease-related risk factor or with Framingham score (-0.01, 95% confidence interval = -1.34 to 1.31).
  
  
  CONCLUSIONS
  Lifetime exposure to estrogen does not appear to be cardioprotective via the cardiovascular disease-related risk factors examined.
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Shiu Lun
authors.initials: SL
authors.lastname: Au Yeung
authors.affiliation: Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK.
authors.forename: Kar Keung
authors.initials: KK
authors.lastname: Cheng
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Molecular Epidemiological Research Centre, Guangzhou Number 12 Hospital, Guangzhou, China.
authors.forename: Weisen
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Molecular Epidemiological Research Centre, Guangzhou Number 12 Hospital, Guangzhou, China. Electronic address: cqjiang@hkucc.hku.hk.
authors.forename: Chaoqiang
authors.initials: C
authors.lastname: Jiang
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Tai Hing
authors.initials: TH
authors.lastname: Lam
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
authors.forename: Gabriel Matthew
authors.initials: GM
authors.lastname: Leung
authors.affiliation: School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; City University of New York School of Public Health and Hunter College, New York.
authors.forename: C Mary
authors.initials: CM
authors.lastname: Schooling
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000235:genetics* / Q000378:metabolism; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D004958:Estradiol / Q000235:genetics* / Q000378:metabolism; D005260:Female; D005819:Genetic Markers; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D057182:Mendelian Randomization Analysis; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D012307:Risk Factors; D055815:Young Adult
chemical_list: D005819:Genetic Markers; D004958:Estradiol
keywords: Cardiovascular risk factors; Chinese; Estrogen; Mendelian randomization analysis; Women