Glucose and insulin components of the metabolic syndrome are associated with hyperandrogenism in postmenopausal women - The Atherosclerosis Risk in Communities Study
Glucose and insulin components of the metabolic syndrome are associated with hyperandrogenism in postmenopausal women - The Atherosclerosis Risk in Communities Study
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DOI：
10.1093/aje/kwh250
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发表时间：
2004-09-15
影响因子：
5
通讯作者：
Dobs, A
中科院分区：
文献类型：
--
作者：
Golden, SH;Ding, J;Dobs, A
1990-1992年，在一项流行的颈动脉粥样硬化病例对照研究中，作者调查了未接受激素替代治疗的绝经后美国妇女（n = 362）总睾酮和游离睾酮与代谢综合征的关系。使用游离雄激素指数（FAI）（总睾酮/性激素结合球蛋白比率）估计游离睾酮。代谢综合征被定义为存在以下三个或更多标准：腰围大于等于35英寸（88.9厘米），甘油三酯大于等于150毫克/分升，高密度脂蛋白胆固醇130/80毫米汞柱，空腹胰岛素大于等于100 pmol/升，或葡萄糖稳态受损（空腹血糖大于等于110毫克/分升或诊断为糖尿病）。FAI，而不是总睾酮，与代谢综合征密切相关。与最低FAI四分位数的女性相比，在调整年龄、种族和颈动脉粥样硬化状态后，最高四分位数的女性患代谢综合征的几率高出五倍（优势比= 5.38,95%置信区间：2.70,10.7）。在多变量分析中，包含高胰岛素血症和高血糖的三组分代谢综合征组合与FAI增加最密切相关（与没有这些组合的女性相比，绝对增加= 0.41-0.54；所有p < 0.001）。较高的FAI与代谢综合征的高胰岛素血症和高血糖相关。雄激素在绝经后妇女血糖稳态中的作用有待进一步研究。
In 1990-1992, the authors investigated the association of total and free testosterone with the metabolic syndrome in postmenopausal US women not taking hormone replacement therapy (n = 362) in a prevalent case-control study of carotid atherosclerosis. Free testosterone was estimated by using the free androgen index (FAI) (total testosterone/sex hormone-binding globulin ratio). The metabolic syndrome was defined as the presence of three or more of the following criteria: waist circumference greater than or equal to35 inches (88.9 cm), triglycerides greater than or equal to150 mg/dl, high density lipoprotein cholesterol 130/80 mmHg, fasting insulin greater than or equal to100 pmol/liter, or impaired glucose homeostasis (fasting glucose greater than or equal to110 mg/dl or diagnosed diabetes mellitus). FAI, but not total testosterone, was strongly associated with the metabolic syndrome. Compared with women in the lowest FAI quartile, those in the highest quartile had a fivefold greater odds of having the metabolic syndrome (odds ratio = 5.38, 95% confidence interval: 2.70, 10.7) after adjustment for age, race, and carotid atherosclerosis status. In multivariate analyses, the three-component metabolic syndrome combinations that contained both hyperinsulinemia and hyperglycemia were most strongly associated with increased FAI (absolute increase = 0.41-0.54 compared with that for women who did not have these combinations; all p's < 0.001). Higher FAI was associated with the hyperinsulinemia and hyperglycemia components of the metabolic syndrome. The role of androgens in glucose homeostasis in postmenopausal women requires further study.