Influence of sex and hormone status on circulating natriuretic peptides
Open accessAbstract
Objectives The aim of this study was to assess the relationship between sex hormones and natriuretic peptide levels in community-based adults.Background Women have higher circulating natriuretic peptide concentrations than men, but the mechanisms for these sex-related differences and the impact of hormone therapy are unclear. Experimental studies suggest that androgens may suppress natriuretic peptide secretion.Methods We measured N-terminal pro-B-type natriuretic peptide (NT-proBNP), total testosterone, and sex hormone-binding globulin plasma levels in 4,056 men and women (mean age 40 ± 9 years) from the Framingham Heart Study Third-Generation cohort. Sex/hormone status was grouped as: 1) men; 2) post-menopausal women not receiving hormone replacement therapy; 3) pre-menopausal women not receiving hormonal contraceptives; 4) post-menopausal women receiving hormone replacement therapy; and 5) pre-menopausal women receiving hormonal contraceptives.Results Circulating NT-proBNP levels were associated with sex/hormone status (overall p < 0.0001). Men had lower NT-proBNP levels than women of all menopause or hormone groups, and women receiving hormonal contraceptives had higher NT-proBNP levels than women who were not receiving hormone therapy (all p < 0.0001). These relationships remained significant after adjusting for age, body mass index, and cardiovascular risk factors. Across sex/hormone status groups, free testosterone (FT) levels decreased and sex hormone-binding globulin levels increased in tandem with increasing NT-proBNP levels. In sex-specific analyses, NT-proBNP levels decreased across increasing quartiles of FT in men (p for trend <0.01) and women (p for trend <0.0001). Adjustment for FT markedly attenuated the association between sex/hormone status and NT-proBNP concentrations.Conclusions These findings suggest that lower levels of circulating androgens and the potentiating effect of exogenous female hormone therapy contribute to the higher circulating NT-proBNP concentrations in women.
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The relatively low endogenous testosterone levels in women with PCOS compared with men do not seem to have any major influence on MR-proANP levels.
“Based on these findings, the relatively low endogenous testosterone levels in women with PCOS compared with men do not seem to have any major influence on MR-proANP levels.”
From Effect of liraglutide on atrial natriuretic peptide, adrenomedullin, and copeptin in PCOS (2018) · cites this paper as [41]
Studies in other populations and a study administering testosterone therapy in women with hypoandrogenemia point to an inverse correlation between NPs and testosterone.
“Regarding testosterone, studies in other populations and a study administering testosterone therapy in women with hypoandrogenemia point to an inverse correlation between NPs and testosterone (41, 42).”
From Effect of liraglutide on atrial natriuretic peptide, adrenomedullin, and copeptin in PCOS (2018) · cites this paper as [41]
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- Authors
- Lam, C. S. P., Cheng, S., Choong, K., Larson, M. G., Murabito, J. M., Newton-Cheh, C., Bhasin, S., McCabe, E. L., Miller, K. K., Redfield, M. M., Vasan, R. S., Coviello, A. D., & Wang, T. J.
- Affiliations
- Boston University (US)
- Harvard University (US)
- Framingham Heart Study (US)
- Mayo Clinic (US)
- Corresponding author
- Lam, Carolyn S.P.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2011-08
- Volume
- 58
- Issue
- 6
- Pages
- 618-626
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC3170816
- OpenAlex
- W2054473272
- Cited by
- 181
- References
- 47
- Citations by year
- 2026: 14 · 2025: 11 · 2024: 13 · 2023: 19 · 2022: 17 · 2021: 20 · 2020: 16 · 2019: 18 · 2018: 14 · 2017: 7 · 2016: 3 · 2015: 5 · 2014: 6 · 2013: 8 · 2012: 5
- FWCI
- 6.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01hc25195-41-0-1, NO1-HC-25195)
- National Heart, Lung, and Blood Institute (HL-84907, HC25195, R01HL086875, N01‐HC25195, N01-HC-025195, U01HL084907, R01HL094755, NO1‐HC‐25195)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- natriuretic peptides, NT-proBNP, sex differences, sex hormones, testosterone, sex hormone-binding globulin, menopause, hormone replacement therapy, hormonal contraception, androgens, women's cardiovascular health
- MeSH terms
- Adult, Contraceptives, Oral, Estrogens, Female, Humans, Insulin Resistance, Male, Middle Aged, Peptide Fragments, Sex Factors, Sex Hormone-Binding Globulin, Testosterone, Premenopause, Postmenopause, Natriuretic Peptide, Brain, Natriuretic Peptides
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