Sharma A, Ogunmoroti O, Fashanu OE, et al. - Some links of sex hormones (SH) with extra-coronary calcification (ECC) measures were identified in this diverse cohort free of cardiovascular disease (CVD). In particular, an inverse association of free testosterone (T) with prevalent mitral annular calcification (MAC) and descending thoracic aortic calcification (DTAC) progression was found in males, independent of CVD risk factors. Overall, vascular calcification may be influenced by SH.

• SH may explain gender disparities in CVD, and high free T and low sex hormone binding globulin (SHBG) have been linked with coronary artery calcification progression in women.

• A total of 2,737 postmenopausal women (mean age: 65 ± 9 years) and 3,130 men (mean age: 62 ± 10 years) free of clinical CVD with baseline SH levels were included.

• An association of both greater free T and lower SHBG with MAC incidence was found in women in a demographic-adjusted model only.

• Men showed a link of lower free T with MAC prevalence, DTAC incidence and progression, while greater SHBG was related to MAC prevalence as well as DTAC progression after further adjusting for CVD risk factors.