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• W1997614484 abstract "<h3>Objective:</h3> We aimed to investigate the impact of endogenous estradiol (E2) on dementia and to evaluate the contribution of vascular risk factors and inflammatory and blood coagulation markers to this association. <h3>Methods:</h3> Using data from a French population-based prospective study (the Three-City Study) including 5,644 postmenopausal women aged 65 years or older, we investigated the association of endogenous total-E2 and bioavailable-E2 and total-testosterone with the 4-year incidence of all-cause dementia. We further focused on the role of dementia and cardiovascular risk factors as well as inflammation (C-reactive protein, fibrinogen) and hypercoagulability (fibrin d-dimers, thrombin generation) in these associations. We used a case-cohort design consisting of a random subcohort of 562 women not using hormone therapy and 132 incident dementia cases. <h3>Results:</h3> Adjusted Cox proportional hazards models showed a J-shaped relationship between total-E2 and risk of dementia (<i>p</i> = 0.001). Total-E2 values in the lower and upper quartiles were associated with an increased dementia risk (adjusted hazard ratio [HR] [95% confidence interval] = 2.2 [1.1–4.5] and HR = 2.4 [1.2–5.2], respectively). Importantly, the risk associated with higher E2 levels was dramatically increased in women with diabetes compared with nondiabetic women (adjusted HR associated with the upper E2 quartile = 14.2 [1.60–123] and HR = 3.4 [0.1–147], respectively, <i>p</i> interaction <0.05). Similar results were found for bioavailable-E2. Adjustment for inflammatory and blood coagulation markers did not modify our results. No significant association was found for total-testosterone. <h3>Conclusion:</h3> High E2 level is an independent predictor of incident dementia, particularly in postmenopausal women with diabetes." @default.
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• W1997614484 date "2014-01-29" @default.
• W1997614484 modified "2023-10-18" @default.
• W1997614484 title "High plasma estradiol interacts with diabetes on risk of dementia in older postmenopausal women" @default.
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• W1997614484 doi "https://doi.org/10.1212/wnl.0000000000000107" @default.
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