Association of endogenous sex hormones and insulin resistance among postmenopausal women: results from the Postmenopausal Estrogen/Progestin Intervention Trial.
ABSTRACT Most studies of sex hormones and insulin resistance (IR) have focused on androgens; few have examined the association of endogenous estrogens and IR. We determined the cross-sectional association of endogenous levels of total and bioavailable testosterone and estradiol and SHBG with IR among 845 healthy, postmenopausal women aged 45-65 yr. Women were within 10 yr of menopause and not using hormone replacement therapy. Total adiposity was estimated by body mass index, visceral adiposity by waist to hip ratio (WHR), and IR by the homeostasis model assessment. We defined homeostasis model assessment-IR as the highest quartile (cutpoint, 2.1) of the distribution in this cohort. In logistic regression analyses, the odds for IR were significant and increased in a dose-response fashion across each quartile of total estradiol, bioavailable estradiol, and bioavailable testosterone (all P < 0.001 for linear trend). These associations remained significant after adjusting for WHR; adjusted odds ratios were 4.0, 6.1, and 2.7 for total estradiol, bioavailable estradiol, and bioavailable testosterone, respectively, comparing the highest to the lowest quartile (all P < 0.001). Adjusting for body mass index and WHR together eliminated the linear association of IR with total estradiol and bioavailable testosterone, but the association with bioavailable estradiol remained (adjusted odds ratio, 2.7; P < 0.001, comparing the highest to the lowest quartile). IR was not associated with total testosterone before or after adjusting for adiposity. Lower SHBG levels were associated with higher odds of IR, independent of adiposity. These results suggest that estrogen may be equally or more important than testosterone in the pathway to IR in healthy, young postmenopausal women, with differences not entirely explained by body size.
SourceAvailable from: Moyses Szklo[Show abstract] [Hide abstract]
ABSTRACT: Context: Sex hormones may influence adipose tissue deposition, possibly contributing to sex disparities in cardiovascular disease (CVD) risk. Objective: We hypothesized that associations of sex hormone levels with visceral and subcutaneous fat differ by sex. Design, Setting, and Participants: Participants were from the Multi-Ethnic Study of Atherosclerosis with sex hormone levels at baseline and visceral and subcutaneous fat measurements from computed tomography at visit 2 or 3 (n=1835). Main Outcome Measures: Multivariable linear regression was used to investigate the relationships between sex hormones and adiposity. Testing for interaction by sex, race/ethnicity, and age was conducted. Results: In adjusted models, there was a modest significant positive association between estradiol and visceral fat in both sexes (% difference in visceral fat for 1% difference in estradiol in women: 5.44 [1.82, 9.09] in men: 8.22 [0.61, 16.18]). Higher bioavailable testosterone was significantly associated with higher visceral and subcutaneous fat in women and the reverse in men (women: 14.38 [10.23, 18.69] men: -7.69 [-13.06, -1.00]). Higher dehydroepiandosterone was associated with higher visceral fat in women (women: 7.57 [1.71, 13.88]), but not in men (-2.47 [-8.88, 4.29]). Higher sex hormone binding globulin was associated with significantly lower levels of adiposity in both sexes (women: -24.42 [-28.11, -20.55] men: -27.39 [-32.97, -21.34]). There was no significant interaction by race/ethnicity or age. Conclusion: Sex hormones are significantly associated with adiposity, and the associations of androgens differ qualitatively by sex. This heterogeneity may help explain the complexity of the contribution of sex hormones to sex differences in CVD.Journal of Clinical Endocrinology & Metabolism 01/2015; 100(4):jc20142934. DOI:10.1210/jc.2014-2934 · 6.31 Impact Factor
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ABSTRACT: Metabolic syndrome (MetS) is associated with an increased risk of cardiovascular disease. We assessed the associations between MetS and the indicators of carotid atherosclerosis as assessed by ultrasonography taking into consideration of confounders in the general population. A total of 1281 subjects (856 males, 425 females) were included in the present study. The total plaque score and maximum intima-media thickness (IMT) of the carotid arteries were measured as indicators of atherosclerosis. Cardiovascular risk factors were several metabolic components, serum uric acid, serum C-reactive protein (CRP), and lifestyle factors. MetS was defined according to the criteria of the National Cholesterol Education Program. The prevalences of an elevated total plaque score (≥5) and elevated IMT (>1 mm) of the carotid arteries were significantly higher in subjects with MetS as compared to subjects without MetS. Furthermore, a trend was observed towards higher prevalences of these indicators of atherosclerosis as the number of components of MetS increased. Logistic regression analysis revealed a significant association between elevated plaque score and MetS even after adjustments for age, serum uric acid, serum CRP and lifestyle factors in the males. Among the indicators of atherosclerosis assessed by carotid ultrasonography, a significant independent association was observed between the total plaque score and MetS in males in the general population.Heart and Vessels 03/2015; DOI:10.1007/s00380-015-0668-y · 2.11 Impact Factor
Endocrine Reviews 06/2010; 31(3):399-399. DOI:10.1210/edrv.31.3.9983 · 19.36 Impact Factor