TY - JOUR
T1 - Higher serum testosterone concentration in older women is associated with insulin resistance, metabolic syndrome, and cardiovascular disease
AU - Patel, Shrita M.
AU - Ratcliffe, Sarah J.
AU - Reilly, Muredach P.
AU - Weinstein, Rachel
AU - Bhasin, Shalender
AU - Blackman, Marc R.
AU - Cauley, Jane A.
AU - Sutton-Tyrrell, Kim
AU - Robbins, John
AU - Fried, Linda P.
AU - Cappola, Anne R.
N1 - Funding Information:
This work was supported by National Institute on Aging Grant K23 AG19161, an American Federation for Aging Research/Pfizer Research grant, and a career development award from the John A. Hartford Foundation (to A.R.C.); contracts N01-HC-85079 through N01-HC-85086, N01-HC-35129, and N01-HC-15103 from the National Heart, Lung, and Blood Institute; and the Intramural Research Program of the National Institute on Aging. A full list of participating CHS investigators and institutions can be found at http://www.chs-nhlbi.org .
PY - 2009/12
Y1 - 2009/12
N2 - Context: Early postmenopausal women with higher testosterone (T) levels have increased insulin resistance (IR) and cardiovascular risk factors, but whether this translates into increased cardiovascular disease later in life is unknown. Objective: The objective of the study was to determine whether higher T levels are associated with IR, the metabolic syndrome (MetSyn), and coronary heart disease (CHD) in elderly women. Design: Total T and free T by equilibrium dialysis were measured using ultrasensitive assays in 344 women aged 65-98 yr enrolled in the Cardiovascular Health Study. Cross-sectional analyses were performed to examine the associations between total and free T and IR, MetSyn, and CHD. Results: There was a stepwise increase in the homeostasis model assessment of insulin resistance with increasing total (P = 0.0.003) and free T (P = 0.02) level and a corresponding decrease in Quantitative Insulin Sensitivity Check Index (P < 0.001 and P = 0.002, respectively). In adjusted models, higher levels of both totalandfree Twerestrongly associated with abdominal obesityandhigh fasting glucose, thetwo MetSyn components most strongly linked to IR. After adjustment, women in the top quartile of total T levels had a 3-fold greater odds of MetSyn (odds ratio 3.15, 95% confidence interval 1.57-6.35) than those in the bottom quartile and a 3-fold greater odds of CHD (odds ratio 2.95, 95% confidence interval 1.2-7.3)thanthoseinsecondquartile, whereasfreeTwasnotsignificantlyassociatedwithMetSynorCHD. Conclusions: Higher levels of T are associated with IR, MetSyn, andCHDin elderly women. Whether T is a marker or mediator of cardiovascular disease in this population merits further investigation.
AB - Context: Early postmenopausal women with higher testosterone (T) levels have increased insulin resistance (IR) and cardiovascular risk factors, but whether this translates into increased cardiovascular disease later in life is unknown. Objective: The objective of the study was to determine whether higher T levels are associated with IR, the metabolic syndrome (MetSyn), and coronary heart disease (CHD) in elderly women. Design: Total T and free T by equilibrium dialysis were measured using ultrasensitive assays in 344 women aged 65-98 yr enrolled in the Cardiovascular Health Study. Cross-sectional analyses were performed to examine the associations between total and free T and IR, MetSyn, and CHD. Results: There was a stepwise increase in the homeostasis model assessment of insulin resistance with increasing total (P = 0.0.003) and free T (P = 0.02) level and a corresponding decrease in Quantitative Insulin Sensitivity Check Index (P < 0.001 and P = 0.002, respectively). In adjusted models, higher levels of both totalandfree Twerestrongly associated with abdominal obesityandhigh fasting glucose, thetwo MetSyn components most strongly linked to IR. After adjustment, women in the top quartile of total T levels had a 3-fold greater odds of MetSyn (odds ratio 3.15, 95% confidence interval 1.57-6.35) than those in the bottom quartile and a 3-fold greater odds of CHD (odds ratio 2.95, 95% confidence interval 1.2-7.3)thanthoseinsecondquartile, whereasfreeTwasnotsignificantlyassociatedwithMetSynorCHD. Conclusions: Higher levels of T are associated with IR, MetSyn, andCHDin elderly women. Whether T is a marker or mediator of cardiovascular disease in this population merits further investigation.
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U2 - 10.1210/jc.2009-0740
DO - 10.1210/jc.2009-0740
M3 - Article
C2 - 19846742
AN - SCOPUS:73249121078
SN - 0021-972X
VL - 94
SP - 4776
EP - 4784
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 12
ER -