Endogenous sex hormone changes in postmenopausal women in the diabetes prevention program.
BACKGROUND
Whether endogenous sex hormones (ESH) [SHBG, estradiol, testosterone, and dehydroepiandrosterone (DHEA)] are altered by intensive lifestyle modification (ILS) or metformin and whether such changes affect glucose levels among dysglycemic postmenopausal women is unclear.


OBJECTIVE
Our objective was to examine intervention impact on ESH and associations with fasting plasma glucose (FPG) and 2-h glucose changes among postmenopausal glucose-intolerant women.


METHODS
We performed a secondary analysis of a randomized controlled trial.


METHODS
Participants included postmenopausal, overweight, glucose-intolerant women not using exogenous estrogen (n = 382) who participated in the Diabetes Prevention Program.


METHODS
Interventions included ILS with the goals of weight reduction of at least 7% of initial weight and 150 min/wk of moderate intensity exercise or metformin or placebo administered 850 mg twice a day.


METHODS
Intervention-related changes in ESH and associations of changes in ESH and glucose levels were evaluated.


RESULTS
ILS significantly increased SHBG and decreased DHEA before and after adjustment for changes in waist circumference and fasting insulin. ILS did not alter estradiol or testosterone. Metformin did not change any ESH. ILS-induced increases in SHBG and declines in DHEA were associated with decreases in FPG and 2-h glucose, and declines in estradiol were associated with decreases in FPG, before and after adjustment for age, FSH, race/ethnicity, changes in waist circumference, and 1/fasting insulin.


CONCLUSIONS
Among postmenopausal glucose-intolerant women not using estrogen, ILS increased SHBG levels and lowered DHEA levels. These changes were associated with lower glucose independent of adiposity and insulin. Metformin effects upon ESH were not significant.
University of Michigan, Ann Arbor, Michigan 48109-5429, USA. cathkim@umich.edu
Catherine
C
Kim
Shengchun
S
Kong
Gail A
GA
Laughlin
Sherita H
SH
Golden
Kieren J
KJ
Mather
Bin
B
Nan
Sharon L
SL
Edelstein
John F
JF
Randolph
Fernand
F
Labrie
Elizabeth
E
Buschur
Elizabeth
E
Barrett-Connor
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000517:prevention & control*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause / Q000097:blood*; D012738:Sex Hormone-Binding Globulin / Q000032:analysis
D001786:Blood Glucose; D012739:Gonadal Steroid Hormones; D012738:Sex Hormone-Binding Globulin