Endogenous sex hormones and glucose tolerance status in postmenopausal women.
BACKGROUND
In postmenopausal women, endogenous estradiol (E2) and free testosterone (T) have been positively associated with glucose intolerance and type 2 diabetes. Most studies have not examined these associations in a large group of postmenopausal women.


OBJECTIVE
The objective was to examine the association between endogenous sex hormones and glucose tolerance in postmenopausal women.


METHODS
This was a cross-sectional study of 1973 postmenopausal women ages 45-84 yr, not taking hormone replacement therapy, in the Multi-Ethnic Study of Atherosclerosis baseline examination.


METHODS
Impaired fasting glucose (IFG) and diabetes were defined based on fasting blood sugar and/or treatment for diabetes. In women with normal glucose tolerance, insulin resistance was estimated using homeostasis model assessment of insulin resistance (HOMA-IR).


RESULTS
Increasing quartiles of bioavailable T and E2 and decreasing quartiles of SHBG were associated with significantly increased odds of IFG and diabetes (all P for trend<0.001). Except for the association of bioavailable T with diabetes, the other associations persisted after multivariable adjustment. Although higher dehydroepiandrostenedione (DHEA) was associated with greater odds of IFG (P for trend=0.02), it was not associated with diabetes. Of 1100 women with normal glucose tolerance, E2 and DHEA were positively associated, and SHBG was inversely associated with HOMA-IR (all P<0.001) after multivariable adjustment. Bioavailable T was associated with HOMA-IR (P<0.001), but not fasting glucose.


CONCLUSIONS
Of postmenopausal women, endogenous bioavailable T, E2, and DHEA were positively associated and SHBG was negatively associated with insulin resistance.
Golden
Sherita Hill
SH
Department of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA. sahill@jhmi.edu
Dobs
Adrian S
AS
Vaidya
Dhananjay
D
Szklo
Moyses
M
Gapstur
Susan
S
Kopp
Peter
P
Liu
Kiang
K
Ouyang
Pamela
P
D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D049628:Body Size; D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood*; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology*; D005951:Glucose Tolerance Test; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D044469:Racial Groups; D013739:Testosterone / Q000097:blood*
D001786:Blood Glucose; D013739:Testosterone; D004958:Estradiol