Higher Serum Testosterone Concentration in Older Women is Associated with Insulin Resistance, Metabolic Syndrome, and Cardiovascular Disease Export

@article{citeulike:6016977, abstract = {Context: 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.Objective: 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.Design: 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.Results: 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.Conclusions: 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. 10.1210/jc.2009-0740}, author = {Patel, Shrita M. and Ratcliffe, Sarah J. and Reilly, Muredach P. and Weinstein, Rachel and Bhasin, Shalender and Blackman, Marc R. and Cauley, Jane A. and Sutton-Tyrrell, Kim and Robbins, John and Fried, Linda P. and Cappola, Anne R.}, citeulike-article-id = {6016977}, citeulike-linkout-0 = {http://dx.doi.org/10.1210/jc.2009-0740}, citeulike-linkout-1 = {http://jcem.endojournals.org/content/jc.2009-0740v1/.abstract}, citeulike-linkout-2 = {http://jcem.endojournals.org/content/jc.2009-0740v1/.full.pdf}, citeulike-linkout-3 = {http://view.ncbi.nlm.nih.gov/pubmed/19846742}, citeulike-linkout-4 = {http://www.hubmed.org/display.cgi?uids=19846742}, day = {21}, doi = {10.1210/jc.2009-0740}, journal = {J Clin Endocrinol Metab}, keywords = {androgen, cardiovascular, femalegonadal, risk, testosterone}, month = {October}, pages = {jc.2009-0740+}, posted-at = {2009-10-27 22:31:54}, priority = {2}, title = {Higher Serum Testosterone Concentration in Older Women is Associated with Insulin Resistance, Metabolic Syndrome, and Cardiovascular Disease}, url = {http://dx.doi.org/10.1210/jc.2009-0740}, year = {2009} }

TY - JOUR ID - citeulike:6016977 L3 - citeulike-article-id:6016977 N2 - Context: 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.Objective: 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.Design: 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.Results: 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.Conclusions: 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. 10.1210/jc.2009-0740 JF - J Clin Endocrinol Metab TI - Higher Serum Testosterone Concentration in Older Women is Associated with Insulin Resistance, Metabolic Syndrome, and Cardiovascular Disease SP - jc.2009-0740 KW - androgen KW - cardiovascular KW - femalegonadal KW - risk KW - testosterone AU - Patel, Shrita AU - Ratcliffe, Sarah AU - Reilly, Muredach AU - Weinstein, Rachel AU - Bhasin, Shalender AU - Blackman, Marc AU - Cauley, Jane AU - Sutton-Tyrrell, Kim AU - Robbins, John AU - Fried, Linda AU - Cappola, Anne PY - 2009/10/21/ UR - http://dx.doi.org/10.1210/jc.2009-0740 ER -