title: Endogenous sex hormones and glucose tolerance status in postmenopausal women.
abstract: 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.
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, Maryland 21205, USA. sahill@jhmi.edu
authors.forename: Sherita Hill
authors.initials: SH
authors.lastname: Golden
authors.forename: Adrian S
authors.initials: AS
authors.lastname: Dobs
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Vaidya
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.forename: Susan
authors.initials: S
authors.lastname: Gapstur
authors.forename: Peter
authors.initials: P
authors.lastname: Kopp
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.forename: Pamela
authors.initials: P
authors.lastname: Ouyang
mesh_terms: 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*
chemical_list: D001786:Blood Glucose; D013739:Testosterone; D004958:Estradiol