Endogenous Sex Hormones, Metabolic Syndrome, and Diabetes in Men and Women

Kim, Catherine; Halter, Jeffrey B.

doi:10.1007/s11886-014-0467-6

Cited by 75 publications

(65 citation statements)

References 73 publications

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“…Consistent with studies comparing persons with and without glucose perturbations (diabetes, IFG, IGT) (Selvin et al, 2007;Colangelo et al, 2009;Grossmann, 2011;Shin et al, 2012;Kim & Halter, 2014), we found weak evidence suggesting that pre-diabetic men had lower total testosterone levels than men without pre-diabetes. This observed inverse, but statistically non-significant, association was also seen when defining pre-diabetes based on IFG, IGT, and HbA1c.…”

Section: Androgenssupporting

confidence: 87%

Pre‐diabetes and serum sex steroid hormones among US men

et al. 2016

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SUMMARYSeveral studies demonstrate a link between diabetes and sex steroid hormones, but the link with pre-diabetes remains elusive. In this study, we hypothesize that pre-diabetes, which is characterised by having impaired fasting glucose and/or impaired glucose tolerance and/or impaired HbA1C, may influence circulating sex steroid hormone concentrations in men. Thus, we investigated whether serum sex steroid hormone concentrations differ between men with and without pre-diabetes. We analyzed data for 1139 men who were aged 20+ years when they participated in the Third National Health and Nutrition Examination Survey. We calculated adjusted geometric mean serum concentrations of total and estimated free testosterone, androstanediol glucuronide, total and estimated free estradiol, and sex hormone-binding globulin (SHBG) in men with and without pre-diabetes. Logistic regression was used to calculate adjusted odds ratios (OR) of lower concentrations of androgens and SHBG, and higher concentrations of estradiol by prediabetes status. Adjusting for age and race/ethnicity, total testosterone concentration was lower among men with (geometric mean: 4.68 ng/mL) than without (5.36 ng/mL, p = 0.01) pre-diabetes. SHBG concentration was also lower in men with (31.67 nmol/L) than without (36.16 nmol/L; p = 0.01) pre-diabetes. Concentrations of the other hormones did not differ between men with and without pre-diabetes. After adjusting for demographic and lifestyle factors, pre-diabetic men had a higher odds of lower testosterone (OR: 2.58; 95% CI: 1.54-4.29), higher free estradiol level (OR: 1.59; 95% CI: 1.14-2.22), and lower SHBG level (OR: 2.27; 95% CI: 1.32-3.92) compared to men without pre-diabetes. These associations were attenuated after adjusting for adiposity (testosterone OR: 1.76; 95% CI 0.95-3.27, free estradiol OR: 1.29, 95% CI: 0.88-1.88, SHBG OR: 1.71; 95% CI 0.88-3.30). Our findings suggest that men with prediabetes have lower circulating total testosterone and SHBG and higher free estradiol levels.

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Section: Androgenssupporting

confidence: 87%

Pre‐diabetes and serum sex steroid hormones among US men

et al. 2016

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“…However, it is also possible that unmeasured factors, such as earlier brain characteristics and/or common pathways (i.e., developmental, environmental, and/or genetic mechanisms), might have influenced both hormonal profiles and brain volumes in early adulthood and mid‐life and resulted in their observed associations. Given the involvement of sex hormone levels in several developmental and biological processes and given data indicating that they are often involved in bidirectional mechanisms (Allan & McLachlan, 2010; Kim & Halter, 2014), it is possible that their association with brain health is also bidirectional. Future studies are needed to establish the temporality of the association throughout the life‐course.…”

Section: Discussionmentioning

confidence: 99%

Sex hormones and brain volumes in a longitudinal study of middle‐aged men in the CARDIA study

et al. 2017

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IntroductionSeveral findings suggest that testosterone (T) is neuroprotective and that declining T levels during aging are associated with cognitive and brain pathologies; however, little is known on T and brain health in middle‐age. We examined the relationships of total T, bioavailable T, and sex hormone binding globulin (SHBG) levels with total and regional gray matter (GM) and white matter (WM) volumes in middle‐aged men. We also evaluated the association of sex hormone levels with cognitive function.MethodsAnalysis included 267 community‐dwelling men participating in the Coronary Artery Risk Development in Young Adults (CARDIA) brain magnetic resonance imaging (MRI) substudy. Total T, bioavailable T, and SHBG levels were measured at three times from the 2nd to 4th decade of life; brain volumes were measured at the ages of 42–56. Associations were estimated using linear regression models, adjusted for several potential confounders.ResultsHigher SHBG levels were associated with greater total WM volume (+3.15 cm3 [95% confidence interval [CI] = 0.01, 6.28] per one standard deviation higher SHBG). Higher SHBG levels were associated with lower total and regional GM volumes overall and significantly with smaller parietal GM volume (−0.96 cm3 [95%CI = −1.71, −0.21]). T levels were not related to brain volumes. Neither T nor SHBG levels were associated with cognitive function.ConclusionResults suggest a role for SHBG in structural brain outcomes in men and emphasize the value of investigating SHBG levels as modulators of sex hormone and metabolic pathways regulating brain and behavioral characteristics in men.

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“…However, in examinations of conventional lipid profiles, greater androgenicity (as represented by higher testosterone [T], lower estradiol [E2], and lower sex hormone binding globulin [SHBG]) has been associated with more atherogenic profiles in women and less atherogenic profiles in men, and such associations are partially mediated and/or attenuated after adjustment for visceral and hepatic adiposity. 8 Therefore, we examined the relationships between endogenous sex hormone levels and lipoprotein subclasses using data from preliminary studies of the MASALA study, a cohort of Asian Indians in the United States. 9 The aim of this secondary analysis was to determine whether more androgenic profiles were associated with more atherogenic lipoprotein subfraction profiles in women and less atherogenic lipoprotein profiles in men and whether such associations persisted after consideration of adipose tissue mass.…”

Section: Introductionmentioning

confidence: 99%

Endogenous Sex Steroid Hormones, Lipid Subfractions, and Ectopic Adiposity in Asian Indians

Kim

Kong

Krauss³

et al. 2015

Metabolic Syndrome and Related Disorders

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Background: Estradiol, testosterone (T), and sex hormone binding globulin (SHBG) levels are associated with lipid subfractions in men and women. Our objective was to determine if associations are independent from adipose tissue area among Asian Indians. Methods: We used data from 42 women and 57 Asian Indian men who did not use exogenous steroids or lipidlowering medications. Lipoprotein subfractions including low-density lipoprotein cholesterol (LDL), very low-density lipoprotein cholesterol (VLDL), and intermediate density lipoprotein (IDL) were assessed by ion mobility spectrometry. Intra-abdominal adiposity was assessed by computed tomography. Multivariable regression models estimated the association between sex hormones with lipoprotein subfractions before and after adjustment for adiposity. Results: Among women, lower log SHBG levels were associated with smaller log LDL particle size and higher log triglycerides, log VLDL, and log IDL, although these associations were attenuated with adjustment for visceral adiposity in particular. Among women, lower log SHBG levels was significantly associated with lower log medium LDL and log small LDL concentrations even after consideration of visceral and hepatic adiposity and insulin resistance as represented by the homeostasis model assessment of insulin resistance (HOMA-IR). Among men, lower log SHBG was also associated with smaller log LDL peak diameter size and higher log triglycerides and log VLDL, even after adjustment for HOMA-IR and adiposity. Relationships between sex steroids and lipid subfractions were not significant among women. Among men, higher total testosterone was associated with higher log HDL and log LDL particle size, and lower log triglycerides and log VLDL, but these associations were partially attenuated with adjustment for adiposity and HOMA-IR. Conclusions: Among Asian Indians, SHBG is associated with more favorable lipid subfraction concentrations, independent of hepatic and visceral fat.

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Endogenous Sex Hormones, Metabolic Syndrome, and Diabetes in Men and Women

Cited by 75 publications

References 73 publications

Pre‐diabetes and serum sex steroid hormones among US men

Pre‐diabetes and serum sex steroid hormones among US men

Sex hormones and brain volumes in a longitudinal study of middle‐aged men in the CARDIA study

Endogenous Sex Steroid Hormones, Lipid Subfractions, and Ectopic Adiposity in Asian Indians

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