The age-associated decline of androgens in reproductive age and menopausal Black and White women.
BACKGROUND
The effect of race and obesity on the age-associated decline of androgens in reproductive-aged and menopausal women has not been well characterized.


OBJECTIVE
Our objective was to determine the impact of racial differences and body mass index (BMI) on the change in androgen levels during a woman's reproductive and early menopausal years.


METHODS
We conducted a frequency-matched cross-sectional study at a tertiary academic medical center.


METHODS
Subjects included 260 healthy, nonhirsute and eumenorrheic, self-identified Black and White women, ages 15-60 yr.


METHODS
A medical and reproductive history, physical exam, and blood sampling were determined in the fasting state during the early follicular phase.


METHODS
Serum levels of androgens or androgen metabolites (dehydroepiandrosterone sulfate, androstenedione, and total and free testosterone) and SHBG were measured and the BMI, the waist-to-hip ratio (WHR), and the basal insulin resistance estimated by the homeostasis model assessment for insulin resistance determined.


RESULTS
After controlling for differences in BMI, insulin resistance, and WHR, Black women had lower androgen levels than age-matched White women. All androgens, or androgen metabolites, declined similarly across the reproductive lifespan and menopausal transition in both Black and White women. Race was a significant predictor of dehydroepiandrosterone sulfate, androstenedione, and total and free testosterone but not SHBG.


CONCLUSIONS
Eumenorrheic, nonhirsute Black women have a lower range of normal androgen levels than White women of the same age, BMI, WHR, and homeostasis model assessment index for insulin resistance. Race and age-adjusted data should be considered when evaluating androgen levels in women between the ages of 15 and 60 yr.
Spencer
Jessica B
JB
Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, 8635 West Third Street, Suite 160W, Los Angeles, California 90048, USA.
Klein
Mitchel
M
Kumar
Ashim
A
Azziz
Ricardo
R
D000293:Adolescent; D000328:Adult; D000375:Aging / Q000097:blood*; D000728:Androgens / Q000097:blood*; D000735:Androstenedione / Q000097:blood; D044383:Black People; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008593:Menopause / Q000097:blood*; D008875:Middle Aged; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013739:Testosterone / Q000097:blood; D049629:Waist-Hip Ratio; D044465:White People
D000728:Androgens; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D000735:Androstenedione; D019314:Dehydroepiandrosterone Sulfate