The association of endogenous sex hormones, adiposity, and insulin resistance with incident diabetes in postmenopausal women

In postmenopausal women, endogenous bioavailable testosterone (T) and estradiol (E2) have been positively associated, and SHBG has been negatively associated, with incident type 2 diabetes (T2DM). Previous studies have not explored possible factors explaining these relationships. Our objective was t...

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Veröffentlicht in:The journal of clinical endocrinology and metabolism Jg. 94; H. 11; S. 4127
Hauptverfasser: Kalyani, Rita Rastogi, Franco, Manuel, Dobs, Adrian S, Ouyang, Pamela, Vaidya, Dhananjay, Bertoni, Alain, Gapstur, Susan M, Golden, Sherita Hill
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 01.11.2009
Schlagworte:
Adipose Tissue - anatomy & histology
Adiposity - physiology
Aged
Aged, 80 and over
Blood Glucose - analysis
Cohort Studies
Dehydroepiandrosterone - blood
Diabetes Mellitus - blood
Diabetes Mellitus - diagnosis
Diabetes Mellitus - epidemiology
Diabetes Mellitus - physiopathology
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - diagnosis
Estradiol - blood
Ethnicity
Fasting
Female
Glucose Intolerance - blood
Glucose Intolerance - diagnosis
Glucose Intolerance - epidemiology
Humans
Longitudinal Studies
Middle Aged
Postmenopause
Proportional Hazards Models
Sex Hormone-Binding Globulin - metabolism
Testosterone - blood
ISSN:1945-7197, 1945-7197
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Zusammenfassung:In postmenopausal women, endogenous bioavailable testosterone (T) and estradiol (E2) have been positively associated, and SHBG has been negatively associated, with incident type 2 diabetes (T2DM). Previous studies have not explored possible factors explaining these relationships. Our objective was to examine the association of endogenous sex hormones with incident T2DM in postmenopausal women and possible explanatory factors. The Multi-Ethnic Study of Atherosclerosis (MESA) is a prospective study that included 1612 postmenopausal women aged 45-84 yr, followed between the years 2000-2006, who were not taking hormone replacement therapy, had no prevalent cardiovascular disease or diabetes, and had complete ascertainment of sex hormones. T2DM was defined based on fasting glucose and/or treatment for diabetes. There were 116 incident cases of diabetes during follow-up. Across higher quartiles of bioavailable T and E2 and lower quartiles of SHBG, we found significantly greater hazards of developing incident T2DM (all P for trend <or=0.001). After adjustment for body mass index and insulin resistance estimated by homeostasis model assessment of insulin resistance, bioavailable T was no longer associated with incident T2DM. The associations of E2 and SHBG with incident T2DM were partially explained by body mass index and insulin resistance but persisted in fully adjusted models (both P for trend <0.02). Dehydroepiandrosterone had no relationship with incident T2DM. Adiposity and insulin resistance explained most of the association of bioavailable T but only partially explained the associations of E2 and SHBG with incident T2DM among postmenopausal women.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1945-7197
1945-7197
DOI:10.1210/jc.2009-0910