Testosterone and sex hormone-binding globulin predict the metabolic syndrome and diabetes in middle-aged men

被引:689
作者
Laaksonen, DE
Niskanen, L
Punnonen, K
Nyyssönen, K
Tuomainen, TP
Valkonen, VP
Salonen, R
Salonen, JT
机构
[1] Univ Kuopio, Publ Hlth Res Inst, Dept Physiol, FIN-70211 Kuopio, Finland
[2] Kuopio Univ Hosp, Dept Clin Chem, SF-70210 Kuopio, Finland
[3] Kuopio Univ Hosp, Dept Med, SF-70210 Kuopio, Finland
[4] Univ Kuopio, Dept Publ Hlth & Gen Practice, Publ Hlth Res Inst, FIN-70211 Kuopio, Finland
[5] Inner Savo Hlth Ctr, Suonenjoki, Finland
关键词
D O I
10.2337/diacare.27.5.1036
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE - In men, hypoandrogenism is associated with features of the metabolic syndrome, but the role of sex hormones in the pathogenesis of the metabolic syndrome and diabetes is not well understood. We assessed the association of low levels of testosterone and sex hormone-binding globulin (SHBG) with the development of the metabolic syndrome and diabetes in men. RESEARCH DESIGN AND METHODS - Concentrations of SHBG and total and calculated free testosterone and factors related to insulin resistance were determined at baseline in 702 middle-aged Finnish men participating in a population-based cohort study. These men had neither diabetes nor the metabolic syndrome. RESULTS - After 11 years of follow-up, 147 men had developed the metabolic syndrome (National Cholesterol Education Program criteria) and 57 men diabetes. Men with total testosterone, calculated free testosterone, and SHBG levels in the lower fourth had a severalfold increased risk of developing the metabolic syndrome (odds ratio [OR] 2.3, 95% Cl 1.5-3.4; 1.7, 1.2-2.5; and 2.8, 1.9-4.1, respectively) and diabetes (2.3, 1.3-4.1; 1.7, 0.9-3.0, and 4.3, 2.4-7.7, respectively) after adjustment for age. Adjustment for potential confounders such Lis cardiovascular disease, smoking, alcohol intake, and socioeconomic status did not alter the associations. Factors related to insulin resistance attenuated the associations, but they remained significant, except for free testosterone. CONCLUSIONS - Low total testosterone and SHBG levels independently predict develop-ment of the metabolic syndrome and diabetes in middle-aged men. Thus, hypoandrogenism is an early marker for disturbances in insulin and glucose metabolism that may progress to the metabolic syndrome or frank diabetes and may contribute to their pathogenesis.
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页码:1036 / 1041
页数:6
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