Associations of sex hormone-binding globulin and testosterone with diabetes among men and women (the Saku Diabetes study): a case control study

Abstract

BackgroundSex hormone-binding globulin (SHBG) levels and sex hormones have been implicated in the pathogenesis of type 2 diabetes and cardiovascular diseases. As fatty liver has been suggested to be a major determinant of SHBG levels, we examined whether the associations of SHBG and testosterone with diabetes were independent of fatty liver.MethodsWe conducted a case–control study that included 300 diabetes cases (215 men and 85 women) and 300 matched controls from the Saku cohort study. Diabetes was defined by either fasting plasma glucose levels ≥126 mg/dL, 2-h post-load glucose levels ≥200 mg/dL after a 75 g oral glucose tolerance test, or diabetes diagnosed by physicians. We fitted conditional logistic regression models to examine the associations between SHBG and total testosterone levels with diabetes by sex. To evaluate the impact of fatty liver, we used the fatty liver index (FLI), a validated measure derived from serum triglyceride levels, body mass index (BMI), waist circumference, and γ-glutamyltransferase levels.ResultsAfter adjusting for age, family history of diabetes, smoking, physical activity, BMI, and FLI, SHBG levels were inversely associated with diabetes among women (odds ratio [OR] comparing the highest with the lowest quartiles, 0.13 [95% confidence interval {CI}, 0.02–0.96]), but not among men. Similar patterns were observed in a subgroup analysis restricted to postmenopausal women"(OR, 0.12 [95% CI, 0.01–1.17]). In contrast, testosterone levels were inversely associated with diabetes among men (OR, 0.45 [95% CI, 0.23–0.89]), but not among women.ConclusionsOur findings suggest that SHBG in women and testosterone in men may be inversely associated with diabetes.

Study of Endogenous Sex Hormones and Inflammation in Elderly Women With Diabetes Mellitus

“…In our study, we found a significant increase in mean ± SD of BMI in patient groups (29.32.9 kg / m 2 ) in comparison with control subjects (27.91.7 kg / m 2 ) (p= 0.03).This result was matched with the results of Goto et al (14) and Huffman et al (35) , Oh et al , Ding et al (46) and Kalyani et al (17) who found that elderly diabetic postmenopausal females had higher WC and BMI than non diabetic females.…”

“…This result was matched with result of Goto et al (14) who showed no association between testosterone and BMI in diabetic's elderly women. Also McTiernan et al (71) , Kalish et al (80) and Oh et al (43) they found no association between testosterone, BMI and WHR in diabetics postmenopausal women.…”

“…This result was matched with result of Goto et al (14) who found that serum level of total testosterone was not significantly different between diabetic postmenopausal group and control group in the same line went the result of Golden et al (47) , who found that after adjustment for BMI, race/ethnic differences total and bioavailable testosterone were no longer significant between the diabetic and healthy postmenopausal women. Also Phillips et al (55) and Oh et al (43) found that total testosterone levels were insignificantly associated with the risk of developing DM, even after adjustment for other metabolic parameters.…”

“…CRP levels increased with age, was higher in women than in men, in hypertensive or diabetic subjects and was lower in physically active people and CRP levels considerably increased with BMI. Also Goto et al (14) and Kalyani et al (17) who found that there was a significant difference in hs-CRP in diabetic postmenopausal women compared to non diabetics women, diabetics patients tended to have higher BMI, waist circumference , HbA1c, fasting glucose levels and fasting insulin levels than controls. This is in line with result of DeRekeneire et al…”

Prostate Cancer Risk in Pre-Diabetic Men: A Matched Cohort Study

“…Evidence suggests that metabolic factors associated with DM impact on the hypothalamic-pituitary-testicular axis, 3 and there is a clear inverse relationship between testosterone levels and DM. [4][5][6] Since testosterone also plays an important role in the development and progression of prostate cancer, 7,8 lower levels of testosterone in diabetic patients may lessen the risk for prostate cancer. 1 The problem, however, is that DM is a progressive disease associated with a number of physiological changes that start before its clinical onset (figure 1).…”