Follicle‐Stimulating Hormone, Its Association with Cardiometabolic Risk Factors, and 10‐Year Risk of Cardiovascular Disease in Postmenopausal Women

BACKGROUND: Cardiovascular disease is the leading cause of mortality in postmenopausal women. Follicle‐stimulating hormone (FSH) shows negative associations with obesity and diabetes mellitus in postmenopausal women. We aimed to study the associations between FSH and 10‐year risk of atherosclerotic cardiovascular disease (ASCVD) in postmenopausal women. METHODS AND RESULTS: SPECT‐China (the Survey on Prevalence in East China for Metabolic Diseases and Risk Factors) is a 22‐site, population‐based study conducted during 2014–2015. This study included 2658 postmenopausal women. A newly developed effective tool for 10‐year ASCVD risk prediction among Chinese was adopted. Regression analyses were performed to assess the relationship among FSH, 10‐year ASCVD risk, and multiple cardiometabolic risk factors. With the increase in FSH quartiles, the mean 10‐year ASCVD risk in postmenopausal women decreased from 4.9% to 3.3%, and most metabolic parameters were significantly ameliorated (all P for trend <0.05). In regression analyses, a 1‐SD increment in ln‐FSH was negatively associated with continuous (B −0.12, 95% confidence interval, −0.16, −0.09, P<0.05) and categorical (odds ratio 0.65, 95% confidence interval, 0.49, 0.85, P<0.05) 10‐year ASCVD risk. These significant associations existed in subgroups with or without medication use, obesity, diabetes mellitus, hypertension, and dyslipidemia. Body mass index and waist circumference (both B −0.35, 95% confidence interval, −0.40, −0.30, P<0.05) had the largest associations of all metabolic measures, and blood pressure had the smallest association. CONCLUSIONS: Serum FSH levels were negatively associated with 10‐year ASCVD risk in postmenopausal women. Among cardiometabolic factors, obesity indices had the largest associations with FSH. These results indicated that a low FSH might be a risk factor or a biomarker for cardiovascular disease risk in postmenopausal women.