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Differences in Serum Sex Hormone and Plasma Lipid Levels in Caucasian and African-American Premenopausal Women

Lipid Metabolism Laboratory, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging (S.L.-F., J.R.M., E.J.S.), Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (S.L.-F., J.B.B., M.N.W., E.J.S., S.L.G.), and Department of Family Medicine and Community Health, School of Medicine (J.B.B., M.N.W., C.M., S.L.G.), Tufts University, Boston, Massachusetts 02111; Department of Medicine (C.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655; and Harvard Medical School (B.R.), Boston, Massachusetts 02115

Address all correspondence and requests for reprints to: Stefania Lamon-Fava, M.D., Ph.D., Lipid Metabolism Laboratory, Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, Massachusetts 02111. E-mail: stefania.lamon-fava{at}tufts.edu.

Context: Risk of coronary heart disease is higher in African-American than in Caucasian women.

Objective: The aim of this study was to evaluate the contribution of sex hormone levels, race, and measures of body fat to the variation in plasma lipid levels, a well-established risk factor for coronary heart disease.

Design: This was a cross-sectional study.

Setting: The study was conducted in the general community.

Study Participants: Sixty Caucasian and 117 African-American premenopausal women participated.

Main Outcome Measures: Body weight, body mass index (BMI), and waist to hip circumference ratio (WHR), as well as plasma lipid and serum sex hormone levels, were assessed.

Results: Relative to Caucasian women, African-American women had significantly higher mean BMI (23.92 ± 3.87 vs. 26.99 ± 5.87 kg/m², respectively; P < 0.001), and WHR (0.733 ± 0.052 vs. 0.757 ± 0.068; P < 0.03). Also, plasma triglyceride (TG) levels were significantly lower in African-American women (81 ± 61 vs. 55 ± 24 mg/dl; P < 0.0001). Serum estrone sulfate (556 ± 323 vs. 442 ± 332 pg/ml, Caucasian vs. African-American; P < 0.001), estradiol (E₂) (55.1 ± 43.6 vs. 35.8 ± 17.7 pg/ml; P < 0.0001), androstenedione (2.6 ± 0.9 vs. 1.6 ± 0.7 ng/ml; P < 0.0001), and testosterone (0.36 ± 0.12 vs. 0.31 ± 0.19 ng/ml; P < 0.002) levels were significantly lower in African-American women than in Caucasian women. After correction for the effects of age, BMI, and WHR, serum E₂ levels were significantly and positively associated with plasma high-density lipoprotein cholesterol levels in all women, and serum estrone sulfate levels with plasma total cholesterol and TG levels in African-American women.

Conclusions: Our results indicate that race is an important determinant of plasma TG and serum sex hormone levels, even after adjustment for differences in body size. A significant association between endogenous E₂ and high-density lipoprotein cholesterol levels exists in premenopausal women, independent of their race.

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