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

Tidsskriftartikel - 2010

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Background: Chronic stress may affect morbidity and mortalitythrough neuroendocrine changes, and the ratio of cortisol tosex steroid hormones has been suggested as a biomarker of stress.We aim to address a relation between the ratio of cortisol toestrogens (C/E) and risk of ischaemic heart disease (IHD), hormone-dependentcancers and all-cause mortality among postmenopausal women.Methods: Estradiol and cortisol were measured in a subset of838 women randomly drawn from the second wave of the CopenhagenCity Heart Study (n = 5297 examined in 1981-83) as wellas among all women who developed hormone-dependent cancers afterbaseline. The participants were followed in nationwide registersuntil 2007, with <0.1% loss to follow-up.Results: The C/E ratio was not associated with self-reportedstress, and there were no clear associations with IHD (highestvs lowest quartile: HR = 1.23; 95% confidence interval 0.83-1.81),hormone-dependent cancers (0.69; 0.45-1.08) or all-causemortality (1.10; 0.86-1.41).Conclusions: The C/E ratio was not associated with morbidityand mortality in women, and we cannot replicate the robust findingsof a relation between the cortisol to testosterone ratio andIHD previously reported in men. Whether the C/E ratio is a reasonablebiomarker of stress is debatable.

Reference

Rod N, Kristensen TS, Diderichsen F, Prescott E, Jensen G, Hansen ÅM. Cortisol, estrogens and risk of ischaemic heart disease, cancer and all-cause mortality in postmenopausal women: a prospective cohort study. International Journal of Epidemiology 2010;39(2):530-538.
doi: 10.1093/ije/dyp354

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