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

Rita R. Kalyani, Manuel Franco, Adrian S Dobs, Pamela Ouyang, Dhananjay Vaidya, Alain Bertoni, Susan M. Gapstur, Sherita Hill Golden

Research output: Contribution to journalArticle

Abstract

Context: 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. Objective: Our objective was to examine the association of endogenous sex hormones with incident T2DM in postmenopausal women and possible explanatory factors. Design, Setting, and Participants: 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. Main Outcome Measures: T2DM was defined based on fasting glucose and/or treatment for diabetes. Results: 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 ≤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

Original languageEnglish (US)
Pages (from-to)4127-4135
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume94
Issue number11
DOIs
StatePublished - Nov 2009

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Adiposity
Gonadal Steroid Hormones
Medical problems
Insulin Resistance
Insulin
Body Mass Index
Hormone Replacement Therapy
Type 2 Diabetes Mellitus
Testosterone
Estradiol
Fasting
Atherosclerosis
Homeostasis
Cardiovascular Diseases
Outcome Assessment (Health Care)
Prospective Studies
Glucose
Hazards
Hormones
Therapeutics

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

Cite this

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title = "The association of endogenous sex hormones, adiposity, and insulin resistance with incident diabetes in postmenopausal women",
abstract = "Context: 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. Objective: Our objective was to examine the association of endogenous sex hormones with incident T2DM in postmenopausal women and possible explanatory factors. Design, Setting, and Participants: 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. Main Outcome Measures: T2DM was defined based on fasting glucose and/or treatment for diabetes. Results: 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 ≤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",
author = "Kalyani, {Rita R.} and Manuel Franco and Dobs, {Adrian S} and Pamela Ouyang and Dhananjay Vaidya and Alain Bertoni and Gapstur, {Susan M.} and Golden, {Sherita Hill}",
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T1 - The association of endogenous sex hormones, adiposity, and insulin resistance with incident diabetes in postmenopausal women

AU - Kalyani, Rita R.

AU - Franco, Manuel

AU - Dobs, Adrian S

AU - Ouyang, Pamela

AU - Vaidya, Dhananjay

AU - Bertoni, Alain

AU - Gapstur, Susan M.

AU - Golden, Sherita Hill

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