Higher serum testosterone concentration in older women is associated with insulin resistance, metabolic syndrome, and cardiovascular disease

Shrita M. Patel, Sarah J. Ratcliffe, Muredach P. Reilly, Rachel Weinstein, Shalender Bhasin, Marc R. Blackman, Jane A. Cauley, Kim Sutton-Tyrrell, John A Robbins, Linda P. Fried, Anne R. Cappola

Research output: Contribution to journalArticle

93 Citations (Scopus)

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 totalandfree Twerestrongly associated with abdominal obesityandhigh fasting glucose, thetwo 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)thanthoseinsecondquartile, whereasfreeTwasnotsignificantlyassociatedwithMetSynorCHD. Conclusions: Higher levels of T are associated with IR, MetSyn, andCHDin elderly women. Whether T is a marker or mediator of cardiovascular disease in this population merits further investigation.

Original languageEnglish (US)
Pages (from-to)4776-4784
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume94
Issue number12
DOIs
StatePublished - Dec 2009

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Metabolic Diseases
Insulin Resistance
Testosterone
Cardiovascular Diseases
Insulin
Serum
Coronary Disease
Odds Ratio
Confidence Intervals
Social Adjustment
Dialysis
Assays
Fasting
Homeostasis
Cross-Sectional Studies
Health
Glucose
Population

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology
  • Biochemistry, medical
  • Endocrinology, Diabetes and Metabolism

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Higher serum testosterone concentration in older women is associated with insulin resistance, metabolic syndrome, and cardiovascular disease. / Patel, Shrita M.; Ratcliffe, Sarah J.; Reilly, Muredach P.; Weinstein, Rachel; Bhasin, Shalender; Blackman, Marc R.; Cauley, Jane A.; Sutton-Tyrrell, Kim; Robbins, John A; Fried, Linda P.; Cappola, Anne R.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 94, No. 12, 12.2009, p. 4776-4784.

Research output: Contribution to journalArticle

Patel, SM, Ratcliffe, SJ, Reilly, MP, Weinstein, R, Bhasin, S, Blackman, MR, Cauley, JA, Sutton-Tyrrell, K, Robbins, JA, Fried, LP & Cappola, AR 2009, 'Higher serum testosterone concentration in older women is associated with insulin resistance, metabolic syndrome, and cardiovascular disease', Journal of Clinical Endocrinology and Metabolism, vol. 94, no. 12, pp. 4776-4784. https://doi.org/10.1210/jc.2009-0740
Patel, Shrita M. ; Ratcliffe, Sarah J. ; Reilly, Muredach P. ; Weinstein, Rachel ; Bhasin, Shalender ; Blackman, Marc R. ; Cauley, Jane A. ; Sutton-Tyrrell, Kim ; Robbins, John A ; Fried, Linda P. ; Cappola, Anne R. / Higher serum testosterone concentration in older women is associated with insulin resistance, metabolic syndrome, and cardiovascular disease. In: Journal of Clinical Endocrinology and Metabolism. 2009 ; Vol. 94, No. 12. pp. 4776-4784.
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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 totalandfree Twerestrongly associated with abdominal obesityandhigh fasting glucose, thetwo 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)thanthoseinsecondquartile, whereasfreeTwasnotsignificantlyassociatedwithMetSynorCHD. Conclusions: Higher levels of T are associated with IR, MetSyn, andCHDin elderly women. Whether T is a marker or mediator of cardiovascular disease in this population merits further investigation.",
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T1 - Higher serum testosterone concentration in older women is associated with insulin resistance, metabolic syndrome, and cardiovascular disease

AU - Patel, Shrita M.

AU - Ratcliffe, Sarah J.

AU - Reilly, Muredach P.

AU - Weinstein, Rachel

AU - Bhasin, Shalender

AU - Blackman, Marc R.

AU - Cauley, Jane A.

AU - Sutton-Tyrrell, Kim

AU - Robbins, John A

AU - Fried, Linda P.

AU - Cappola, Anne R.

PY - 2009/12

Y1 - 2009/12

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 totalandfree Twerestrongly associated with abdominal obesityandhigh fasting glucose, thetwo 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)thanthoseinsecondquartile, whereasfreeTwasnotsignificantlyassociatedwithMetSynorCHD. Conclusions: Higher levels of T are associated with IR, MetSyn, andCHDin elderly women. Whether T is a marker or mediator of cardiovascular disease in this population merits further investigation.

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