Plasma sex steroid hormones and risk of developing type 2 diabetes in women: a prospective study
Plasma sex steroid hormones and risk of developing type 2 diabetes in women: a prospective study
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DOI：
10.1007/s00125-007-0785-y
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发表时间：
2007-10-01
期刊：
影响因子：
8.2
通讯作者：
Liu, S.
中科院分区：
文献类型：
--
作者：
Ding, E. L.;Song, Y.;Liu, S.
目的/假设直接调查内源性性激素在糖尿病风险中的作用的前瞻性数据很少，特别是在女性中。我们的目的是全面检查血浆性激素与绝经后妇女发生2型糖尿病风险的关系。方法：我们对绝经后平均年龄为60.3岁和12.2岁的女性卫生专业人员进行了一项前瞻性、巢式病例对照研究，检测血浆雌二醇、睾酮和硫酸脱氢表雄酮与2型糖尿病风险的关系。在未使用激素治疗且无基线心血管疾病、癌症和糖尿病的女性中，在平均10年的随访期间，359例2型糖尿病患者与359例对照患者相匹配。结果雌二醇和睾酮均与2型糖尿病的发病风险呈显著正相关。调整BMI、家族史、生活方式和生殖变量后，比较最高五分位数和最低五分位数的多变量相对危险度（95% CI）分别为：总雌激素12.6(2.83-56.3)（趋势p = 0.002）、游离雌激素13.1(4.18-40.8)（趋势p < 0.001）、总睾酮4.15(1.21-14.2)（趋势p = 0.019）和游离睾酮14.8(4.44-49.2)（趋势p < 0.001）。在调整和考虑其他代谢综合征成分和基线HbA（1c）水平后，这些关联仍然很强。结论/解释在绝经后妇女中，较高的血浆雌二醇和睾酮水平与患2型糖尿病的风险增加密切相关。这些前瞻性数据表明，内源性性激素水平可能在2型糖尿病的发病机制中发挥重要作用。
Aims/hypothesis Prospective data directly investigating the role of endogenous sex hormones in diabetes risk have been scant, particularly in women. We aimed to examine comprehensively plasma sex hormones in connection with risk of developing type 2 diabetes in postmenopausal women.Methods We conducted a prospective, nested case-control study of plasma oestradiol, testosterone and dehydroepiandrosterone sulfate and risk of type 2 diabetes in a cohort of women health professionals with a mean age of 60.3 and 12.2 years since menopause. Among women not using hormone therapy and free of baseline cardiovascular disease, cancer and diabetes, 359 incident cases of type 2 diabetes were matched with 359 controls during an average follow-up of 10 years.Results Oestradiol and testosterone were each strongly and positively associated with risk of type 2 diabetes. After adjustment for BMI, family history, lifestyle and reproductive variables, the multivariable relative risks (95% CI) comparing the highest vs lowest quintile were 12.6 (2.83-56.3) for total oestradiol (p = 0.002 for trend), 13.1 (4.18-40.8) for free oestradiol (p < 0.001 for trend), 4.15 (1.21-14.2) for total testosterone (p = 0.019 for trend) and 14.8 (4.44-49.2) for free testosterone (p < 0.001 for trend). These associations remained robust after adjusting and accounting for other metabolic syndrome components and baseline HbA(1c) levels.Conclusion/interpretation In postmenopausal women, higher plasma levels of oestradiol and testosterone were strongly and prospectively related to increased risk of developing type 2 diabetes. These prospective data indicate that endogenous levels of sex hormones may play important roles in the pathogenesis of type 2 diabetes.