Androgens are associated with hemostatic and inflammatory factors among women at the mid-life

Goal: The goal of this study was to relate annually measured endogenous androgens to hemostatic and inflammation markers in women longitudinally. Methods: A total of 3302 participants from the Study of Women'sHealth Across the Nation, aged 42 - 52 yr at baseline and self- identified as African- American ( 28%), Caucasian ( 47%), Chinese ( 8%), Hispanic ( 8%), or Japanese ( 9%) were evaluated for testosterone ( T), dehydroepiandrosterone sulfate, and SHBG at four time points in 5 yr. Cardiovascular disease markers were fibrinogen, activated factor VII- c, C- reactive protein ( hsC- RP), and the fibrolytic factors, plasminogen activator inhibitor type 1 ( PAI- 1), and tissue plasminogen activator [ t( PA)]. Results: T and free androgen index ( FAI) were associated highly positively with PAI- 1 and t( PA), and FAI was associated highly and positively with hsC- RP. Lower SHBG levels, associated with greater bioavailable T, were associated significantly with higher levels of PAI- 1, t( PA), hsC- RP, and factor VII- c. SHBG was lower in Chinese and Japanese women markedly, resulting in FAI values that, on average, were higher among Chinese and Japanese women compared with African- American, Caucasian, and Hispanic women. Implications: There were strong, positive associations of androgens with fibrolytic and inflammation markers, even after considering age, body size, smoking, and race/ ethnicity. It is important to study androgens, their precursors, and their carrier protein as part of the risk profile for heart disease in mid- aged women.