Ethnic differences in cardiovascular risk factor burden among middle-aged women: Study of Women's Health Across the Nation (SWAN)

Matthews, Karen A.; Sowers, Mary Fran; Derby, Carol A.; Stein, Evan A.; Miracle-McMahill, Heidi L.; Crawford, Sybil L.; Pasternak, Richard C.

doi:10.1016/j.ahj.2004.08.027

Cited by 124 publications

(130 citation statements)

References 22 publications

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“…16 We have also previously reported that E 2 levels did not vary by ethnicity at baseline in SWAN but that FSH levels were higher and testosterone levels lower in both black and Hispanic women compared with whites. 17 Spearman correlations between CV risk factors and hormone values are presented in Table 2.…”

Section: Resultssupporting

confidence: 56%

Sex Hormone–Binding Globulin and the Free Androgen Index Are Related to Cardiovascular Risk Factors in Multiethnic Premenopausal and Perimenopausal Women Enrolled in the Study of Women Across the Nation (SWAN)

et al. 2005

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for the SWAN InvestigatorsBackground-Recent clinical trials have shifted attention away from estrogens and toward androgens and sex hormone-binding globulin (SHBG) as potential mediators of increasing cardiovascular (CV) risk in women at midlife. Methods and Results-The correlation between reproductive hormones and CV risk factors was evaluated in a multiethnic (white, black, Hispanic, Chinese, and Japanese) sample of 3297 premenopausal and perimenopausal women. Testosterone and estradiol (E 2 ) were evaluated along with SHBG and the free androgen index (FAI), the amount of testosterone not bound by SHBG. Low SHBG and high FAI were strongly and consistently related to elevated CV risk factors (higher insulin, glucose, and hemostatic and inflammatory markers and adverse lipids) even after controlling for body mass index (PϽ0.001 for all). Low levels of E 2 were associated with elevated CV risk factors to a lesser degree. These observations were consistent across the 5 ethnic groups. Compared with whites, blacks had higher levels of SHBG and lower levels of FAI, and Chinese had lower levels of SHBG and higher levels of FAI. Conclusions-Low SHBG and high FAI are strongly associated with CV risk factors in racially diverse women, and thus, androgens likely play a role in the CV risk profile of perimenopausal women.

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Section: Resultssupporting

confidence: 56%

Sex Hormone–Binding Globulin and the Free Androgen Index Are Related to Cardiovascular Risk Factors in Multiethnic Premenopausal and Perimenopausal Women Enrolled in the Study of Women Across the Nation (SWAN)

et al. 2005

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“…The institutional review committees of the study sites approved the study, and all participants provided informed consent. Blood samples and questionnaire data regarding demographic variables, lifestyle habits, prevalent medical conditions, and medications were obtained at the baseline visit as described (6 ).…”

Section: Study Populationmentioning

confidence: 99%

“…An important observation in the Study of Women's Health Across the Nation (SWAN) cohort is that CRP concentrations vary significantly between ethnic groups, with the highest concentrations seen in African-American participants, followed in order by Hispanic, white, Chinese, and Japanese participants (6 ). Ethnic differences in CRP concentrations have been found in several other cross-sectional studies, but the basis for these differences is unclear (7)(8)(9)(10)(11).…”

mentioning

confidence: 99%

Ethnic Differences in C-Reactive Protein Concentrations

et al. 2008

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“…8,9 Physiological studies indicate that the same level of BMI confers different metabolic risks in the three groups, 10,11 hence it is unclear about the extent to which obesity categorized in this way can explain ethnic disparities in health, as opposed to other factors such as SES. 12 Recognition of the limitations of BMI as an obesity index has led to proposals for ethnic-specific cutoffs, 13 and incorporation of data on waist girth, again with ethnicspecific cutoffs.…”

Section: Introductionmentioning

confidence: 99%

Body shape in American and British adults: between-country and inter-ethnic comparisons

Wells¹,

Cole

Bruner³

et al. 2007

Int J Obes

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Background: Recent studies indicate differences between British and American white adults, and between income and ethnic groups within the United States, in the population distribution of lifestyle diseases. Differential prevalence of obesity has been suggested as a contributing factor; however, the conventional approach to categorizing obesity, body mass index, is confounded by ethnic variability in physique. Objective: To compare indices of shape between white British and American adults, and between white, African and Hispanic American adults. Design: Analysis of two large National Sizing Surveys, using identical study design and three-dimensional (3D) body-scanning instrumentation, on adults aged 17 þ years from the UK (3907M and 4710F white), and from the USA (1744M and 3329F white, 709M and 1106F African and 639M and 839F Hispanic). Outcome measures: Weight, height, body circumferences. Results: In the United States, socio-economic status was associated with increasing height and decreasing waist girth in white and Hispanic, but not African Americans. Compared to white British, white Americans had larger weight and girths, especially waist girth in men. Relative to white Americans, African Americans had smaller relative waist girth, but larger thigh girth, whereas Hispanic Americans had larger relative waist girth. Conclusions: Body shape of white American adults differs from that of their UK counterparts. Within Americans, ethnic differences in body shape closely track reported differences in prevalence of the metabolic syndrome, implicating variability in central abdominal fat as a key contributing factor. 3D photonic scanning offers a novel approach for categorizing risk of the metabolic syndrome and monitoring treatment success.

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Ethnic differences in cardiovascular risk factor burden among middle-aged women: Study of Women's Health Across the Nation (SWAN)

Cited by 124 publications

References 22 publications

Sex Hormone–Binding Globulin and the Free Androgen Index Are Related to Cardiovascular Risk Factors in Multiethnic Premenopausal and Perimenopausal Women Enrolled in the Study of Women Across the Nation (SWAN)

Sex Hormone–Binding Globulin and the Free Androgen Index Are Related to Cardiovascular Risk Factors in Multiethnic Premenopausal and Perimenopausal Women Enrolled in the Study of Women Across the Nation (SWAN)

Ethnic Differences in C-Reactive Protein Concentrations

Body shape in American and British adults: between-country and inter-ethnic comparisons

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