Title | Higher serum testosterone concentration in older women is associated with insulin resistance, metabolic syndrome, and cardiovascular disease. |
Publication Type | Journal Article |
Year of Publication | 2009 |
Authors | Patel, SM, Ratcliffe, SJ, Reilly, MP, Weinstein, R, Bhasin, S, Blackman, MR, Cauley, JA, Sutton-Tyrrell, K, Robbins, J, Fried, LP, Cappola, AR |
Journal | J Clin Endocrinol Metab |
Volume | 94 |
Issue | 12 |
Pagination | 4776-84 |
Date Published | 2009 Dec |
ISSN | 1945-7197 |
Keywords | Aged, Aged, 80 and over, Blood Glucose, Cardiovascular Diseases, Coronary Disease, Female, Humans, Insulin, Insulin Resistance, Metabolic Syndrome, Odds Ratio, Radioimmunoassay, Socioeconomic Factors, Testosterone, Treatment Outcome |
Abstract | <p><b>CONTEXT: </b>Early postmenopausal women with higher testosterone (T) levels have increased insulin resistance (IR) and cardiovascular risk factors, but whether this translates into increased cardiovascular disease later in life is unknown.</p><p><b>OBJECTIVE: </b>The objective of the study was to determine whether higher T levels are associated with IR, the metabolic syndrome (MetSyn), and coronary heart disease (CHD) in elderly women.</p><p><b>DESIGN: </b>Total T and free T by equilibrium dialysis were measured using ultrasensitive assays in 344 women aged 65-98 yr enrolled in the Cardiovascular Health Study. Cross-sectional analyses were performed to examine the associations between total and free T and IR, MetSyn, and CHD.</p><p><b>RESULTS: </b>There was a stepwise increase in the homeostasis model assessment of insulin resistance with increasing total (P = 0.0.003) and free T (P = 0.02) level and a corresponding decrease in Quantitative Insulin Sensitivity Check Index (P < 0.001 and P = 0.002, respectively). In adjusted models, higher levels of both total and free T were strongly associated with abdominal obesity and high fasting glucose, the two MetSyn components most strongly linked to IR. After adjustment, women in the top quartile of total T levels had a 3-fold greater odds of MetSyn (odds ratio 3.15, 95% confidence interval 1.57-6.35) than those in the bottom quartile and a 3-fold greater odds of CHD (odds ratio 2.95, 95% confidence interval 1.2-7.3) than those in second quartile, whereas free T was not significantly associated with MetSyn or CHD.</p><p><b>CONCLUSIONS: </b>Higher levels of T are associated with IR, MetSyn, and CHD in elderly women. Whether T is a marker or mediator of cardiovascular disease in this population merits further investigation.</p> |
DOI | 10.1210/jc.2009-0740 |
Alternate Journal | J. Clin. Endocrinol. Metab. |
PubMed ID | 19846742 |
PubMed Central ID | PMC2795656 |
Grant List | K23 AG019161 / AG / NIA NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States K23 AG19161 / AG / NIA NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States / / Intramural NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States |