Cortisol, estrogens and risk of ischaemic heart disease, cancer and all-cause mortality in postmenopausal women: a prospective cohort study

TY - JOUR

T1 - Cortisol, estrogens and risk of ischaemic heart disease, cancer and all-cause mortality in postmenopausal women: a prospective cohort study

AU - Rod, Naja Hulvej

AU - Kristensen, Tage S.

AU - Diderichsen, Finn

AU - Prescott, Eva

AU - Jensen, Gorm Boje

AU - Hansen, Åse Marie

AU - Rod, Naja Hulvej

AU - Kristensen, Tage S.

AU - Diderichsen, Finn

AU - Prescott, Eva

AU - Jensen, Gorm B

AU - Hansen, Ase Marie

PY - 2010/4/1

Y1 - 2010/4/1

N2 - Background: Chronic stress may affect morbidity and mortality through neuroen-docrine changes, and the ratio of cortisol to sex steroid hormones has been suggested as a biomarker of stress. We aim to address a relation between the ratio of cortisol to estrogens (C/E) and risk of ischaemic heart disease (IHD), hormone-dependent cancers and all-cause mortality among postmenopausal women. Methods: Estradiol and cortisol were measured in a subset of 838 women randomly drawn from the second wave of the Copenhagen City Heart Study (n = 5297 examined in 1981-83) as well as among all women who developed hormone-dependent cancers after baseline. The participants were followed in nationwide registers until 2007, with < 0.1% loss to follow-up. Results: The C/E ratio was not associated with self-reported stress, and there were no clear associations with IHD (highest vs lowest quartile: HR = 1.23; 95% confidence interval 0.83-1.81), hormone-dependent cancers (0.69; 0.45-1.08) or all-cause mortality (1.10;0.86-1.41). Conclusions: The C/E ratio was not associated with morbidity and mortality in women, and we cannot replicate the robust findings of a relation between the cortisol to testosterone ratio and IHD previously reported in men. Whether the C/E ratio is a reasonable biomarker of stress is debatable.

AB - Background: Chronic stress may affect morbidity and mortality through neuroen-docrine changes, and the ratio of cortisol to sex steroid hormones has been suggested as a biomarker of stress. We aim to address a relation between the ratio of cortisol to estrogens (C/E) and risk of ischaemic heart disease (IHD), hormone-dependent cancers and all-cause mortality among postmenopausal women. Methods: Estradiol and cortisol were measured in a subset of 838 women randomly drawn from the second wave of the Copenhagen City Heart Study (n = 5297 examined in 1981-83) as well as among all women who developed hormone-dependent cancers after baseline. The participants were followed in nationwide registers until 2007, with < 0.1% loss to follow-up. Results: The C/E ratio was not associated with self-reported stress, and there were no clear associations with IHD (highest vs lowest quartile: HR = 1.23; 95% confidence interval 0.83-1.81), hormone-dependent cancers (0.69; 0.45-1.08) or all-cause mortality (1.10;0.86-1.41). Conclusions: The C/E ratio was not associated with morbidity and mortality in women, and we cannot replicate the robust findings of a relation between the cortisol to testosterone ratio and IHD previously reported in men. Whether the C/E ratio is a reasonable biomarker of stress is debatable.

U2 - http://dx.doi.org/10.1093/ije/dyp354

DO - http://dx.doi.org/10.1093/ije/dyp354

M3 - Journal article

SN - 0300-5771

VL - 39

SP - 530

EP - 538

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

IS - 2

ER -