The association between serum follicle-stimulating hormone and luteinizing hormone levels and congestive heart failure in postmenopausal women: a cross-sectional study

This study aims to explore the relationship between follicle-stimulating hormone (FSH) levels, serum luteinizing hormone (LH) levels, and the risk of congestive heart failure (CHF) in postmenopausal women. While earlier investigations have looked into the possible connection between serum sex hormones and heart health, the results have not provided clear conclusions. This study included a total of 2,853 postmenopausal women who visited the People’s Hospital of Xinjiang Uygur Autonomous Region. The associations between FSH, LH, and CHF were explored through univariate and multivariate logistic regression analyses. To analyze the dose-response relationship, a generalized additive model (GAM) was utilized. Additionally, sensitivity analysis, mediation analysis, and subgroup analysis were performed to confirm the reliability of these findings. The discriminatory ability of FSH and LH for distinguishing CHF was assessed using the area under the curve (AUC). Their incremental value was further evaluated with continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Clinical utility was examined using decision curve analysis (DCA). Findings from the comprehensive logistic regression analysis indicated a notable inverse relationship between FSH and LH levels and the occurrence of CHF. The odds ratios (OR) [95% confidence intervals (CI)] corresponding to each standard deviation increase in FSH and LH were 0.75 (0.67 ~ 0.85) and 0.88 (0.78 ~ 0.99), respectively. The GAM identified critical thresholds for FSH and LH. When FSH was below 69.21 mIU/mL, each increase of one standard deviation was associated with a 36% reduction in the risk of HF, OR: 0.64 (0.52–0.78). When LH levels were below 26.49 mIU/mL, each increase of one standard deviation was associated with a 40% reduction in the risk of HF, OR: 0.60 (0.45–0.80). Sensitivity analysis and subgroup analysis both confirmed robustness. Mediation analysis revealed that the association between LH and heart failure was influenced by estrogen and progesterone, whereas FSH was not mediated by these hormones. In summary, this research uncovers a complex relationship between the levels of FSH and LH and the occurrence of CHF in women after menopause. These results emphasize the critical role of hormonal balance in the cardiovascular well-being of postmenopausal females, shedding light on the connection between gonadotropins and CHF. These findings could inform future approaches to the prevention and management of CHF, while also stressing the necessity for extensive prospective studies to confirm these findings and investigate their potential clinical significance.