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Testosterone, Dihydrotestosterone, Sex Hormone Binding Globulin and Incident Diabetes among Older Men: the Cardiovascular Health Study.
Wednesday,2016-12-14 15:45 America/Los_Angeles — ecterry
| Title | Testosterone, Dihydrotestosterone, Sex Hormone Binding Globulin and Incident Diabetes among Older Men: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2016 |
| Authors | Joyce, KE, Biggs, ML, Djoussé, L, Ix, JH, Kizer, JR, Siscovick, DS, Shores, MM, Matsumoto, AM, Mukamal, KJ |
| Journal | J Clin Endocrinol Metab |
| Pagination | jc20162623 |
| Date Published | 2016 Oct 12 |
| ISSN | 1945-7197 |
| Abstract | <p><b>CONTEXT: </b>Although sex hormone binding globulin (SHBG) and testosterone (T) have been inversely associated with risk of diabetes, few studies have examined dihydrotestosterone (DHT), a more potent androgen than T, or older adults, whose glycemic pathophysiology differs from younger adults.</p><p><b>OBJECTIVE: </b>To determine the associations of SHBG, T, and DHT with insulin resistance and incident diabetes in older adult men.</p><p><b>DESIGN: </b>In a prospective cohort study, we evaluated baseline levels of SHBG, T, and DHT using liquid chromatography-tandem mass spectrometry among 852 men in the Cardiovascular Health Study free of diabetes and cardiovascular disease in 1994.</p><p><b>MAIN OUTCOME: </b>Insulin resistance estimated by HOMA-IR and insulin sensitivity estimated by the Gutt index in 1996, and incident diabetes (n=112) ascertained over a mean follow-up of 9.8 years.</p><p><b>RESULTS: </b>In linear regression models adjusted for demographics, alcohol consumption, current smoking, body-mass index, and other androgens, SHBG (HOMA-IR 0.30 units lower per doubling; 95% confidence interval [CI], 0.08-0.52; p=0.01) and total DHT (HOMA-IR 0.18 units lower per doubling; 95% CI 0.06-0.30; p=0.01), but not free T (p=0.33) were inversely associated with insulin resistance. In corresponding Cox proportional hazards models, total DHT was again inversely associated with risk of diabetes (adjusted hazard ratio per doubling 0.69; 95% CI, 0.52-0.92; p=0.01), but SHBG (hazard ratio 1.09; 95% CI, 0.74-1.59; p=0.66) and free T (hazard ratio 1.15; 95% CI, 0.92-1.43; p=0.23) were not.</p><p><b>CONCLUSIONS: </b>Among older men, higher levels of DHT are inversely associated with insulin resistance and risk of diabetes over the ensuing 10 years, while levels of T are not. Future studies are still needed to clarify the role of SHBG in risk of diabetes in this population.</p> |
| DOI | 10.1210/jc.2016-2623 |
| Alternate Journal | J. Clin. Endocrinol. Metab. |
| PubMed ID | 27732332 |
ePub date:
16/10