Sex and reproductive stage modify the effect of endogenous oestrogens on coronary atherosclerosis in rheumatoid arthritis
Authors' conclusion
Sex and reproductive status modified the effect of endogenous oestrogens on atherosclerosis in RA and their associations with inflammation and lipoprotein functions impacting on cholesterol homeostasis.
Study context
- Population
- Patients with rheumatoid arthritis (RA) without CVD, single-centre observational cohort
- Participants
- 140 patients
- Exposure
- Endogenous oestrogens (estrone, estradiol) and coronary atherosclerosis, by sex and menopausal status
- Outcome
- Coronary atherosclerosis (CT angiography) in relation to endogenous oestrogens, by sex and menopause
Methodological detailssingle-centre, CT angiography
- Single-centre
- CT angiography
Main finding
As reported in the abstract
Oestrogens and coronary atherosclerosis, by sex and reproductive stage
- Estrone and estradiol associated with higher coronary artery calcium score in males but not females
- p-for-interaction≤0.023
- Estradiol associated with more coronary plaques in males but not females
- p-for-interaction=0.048
- Estrone linked to fewer plaques in premenopausal women
- p-for-interaction=0.043
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | |
|---|---|---|
| CV risk, per SD increase in estrone | 0.43 (0.21–0.86) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
- CV risk, per SD increase in estrone: not estradiol; particularly among premenopausal women (p-for-interaction=0.015)
Proatherogenic cytokines
- Estrone associated with higher proatherogenic cytokine levels in males and postmenopausal women, lower in premenopausal women
Lipoprotein functions (cholesterol efflux and loading capacity) in males
- Estrone inversely associated with ABCA1-CEC in males
- P for interaction = 0.008
- Estrone inversely associated with ABCG1-CEC in males
- P for interaction = 0.040
- Estradiol positively associated with cholesterol loading capacity (CLC) in males
- P for interaction = 0.044
- Estradiol inversely associated with ABCA1-CEC in males
- P for interaction = 0.010
Original publication
Sex and reproductive stage modify the effect of endogenous oestrogens on coronary atherosclerosis in rheumatoid arthritis. RMD Open. Published 7 December 2025. doi:10.
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