title: Glucose and insulin components of the metabolic syndrome are associated with hyperandrogenism in postmenopausal women: the atherosclerosis risk in communities study.
abstract: In 1990-1992, the authors investigated the association of total and free testosterone with the metabolic syndrome in postmenopausal US women not taking hormone replacement therapy (n=362) in a prevalent case-control study of carotid atherosclerosis. Free testosterone was estimated by using the free androgen index (FAI) (total testosterone/sex hormone-binding globulin ratio). The metabolic syndrome was defined as the presence of three or more of the following criteria: waist circumference > or =35 inches (88.9 cm), triglycerides > or =150 mg/dl, high density lipoprotein cholesterol <40 mg/dl, blood pressure >130/80 mmHg, fasting insulin > or =100 pmol/liter, or impaired glucose homeostasis (fasting glucose > or =110 mg/dl or diagnosed diabetes mellitus). FAI, but not total testosterone, was strongly associated with the metabolic syndrome. Compared with women in the lowest FAI quartile, those in the highest quartile had a fivefold greater odds of having the metabolic syndrome (odds ratio=5.38, 95% confidence interval: 2.70, 10.7) after adjustment for age, race, and carotid atherosclerosis status. In multivariate analyses, the three-component metabolic syndrome combinations that contained both hyperinsulinemia and hyperglycemia were most strongly associated with increased FAI (absolute increase=0.41-0.54 compared with that for women who did not have these combinations; all p's < 0.001). Higher FAI was associated with the hyperinsulinemia and hyperglycemia components of the metabolic syndrome. The role of androgens in glucose homeostasis in postmenopausal women requires further study.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. sgolden1@jhem.jhmi.edu
authors.forename: Sherita Hill
authors.initials: SH
authors.lastname: Golden
authors.forename: Jingzhong
authors.initials: J
authors.lastname: Ding
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.forename: Maria Ines
authors.initials: MI
authors.lastname: Schmidt
authors.forename: Bruce B
authors.initials: BB
authors.lastname: Duncan
authors.forename: Adrian
authors.initials: A
authors.lastname: Dobs
mesh_terms: D002340:Carotid Artery Diseases / Q000453:epidemiology / Q000209:etiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005947:Glucose / Q000378:metabolism; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D017588:Hyperandrogenism / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D006943:Hyperglycemia / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D006946:Hyperinsulinism / Q000453:epidemiology / Q000209:etiology* / Q000378:metabolism; D007328:Insulin / Q000097:blood; D016014:Linear Models; D016015:Logistic Models; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000378:metabolism; D017698:Postmenopause / Q000378:metabolism*; D012307:Risk Factors; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood*; D014481:United States / Q000453:epidemiology
chemical_list: D007328:Insulin; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D005947:Glucose