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Hyperandrogenemia in early adulthood is an independent risk factor for abnormal glucose metabolism in middle age

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Title: Hyperandrogenemia in early adulthood is an independent risk factor for abnormal glucose metabolism in middle age
Authors: Tuorila, K
Ollila, M-M
Järvelin, M-R
Tapanainen, JS
Franks, S
Puukka, K
Piltonen, TT
Morin-Papunen, L
Item Type: Journal Article
Abstract: CONTEXT: The role of androgen excess as a contributing factor to abnormal glucose metabolism (AGM) and insulin resistance in women remains controversial. OBJECTIVE: To investigate whether hyperandrogenemia (HA) estimated by serum testosterone (T) level and free androgen index (FAI) at ages 31 and 46 is associated with insulin resistance, insulin secretion and AGM by age 46. DESIGN: Prospective study including 5,889 females followed at ages 31 and 46. SETTING: General community. PARTICIPANTS: Women with HA were compared with normoandrogenic women at ages 31 and 46. INTERVENTION: None. MAIN OUTCOME MEASUREMENTS: AGM, including pre-diabetes and T2DM, homeostatic model assessments of insulin resistance (HOMA-IR) and of pancreatic β-cell function (HOMA-B). RESULTS: At age 31, HA women displayed increased HOMA-IR P=0.05), HOMA-B (P=0.006), and higher fasting insulin (P=0.034) than normoandrogenic women after adjusting for body mass index (BMI). At age 46, there was a nonsignificant trend towards higher fasting glucose (P=0.07) and glycated hemoglobin A1 (P=0.067) levels in HA women. Women in the highest T quartile (odds ratio [OR]= 1.80;95%CI, 1.15-2.82) at age 31 and in the two highest FAI quartiles at ages 31 (Q4:OR=3.76;95%CI, 2.24-6.32) and 46 (Q4:OR=2.79;95%CI, 1.74-4.46) had increased risk for AGM, independently of BMI, when compared with women in Q1. Sex hormone-binding globulin (SHBG) was inversely associated with AGM (at age 31:Q4:OR=0.37;95%CI, 0.23-0.60, at age 46:Q4:OR=0.28;95%CI, 0.17-0.44). CONCLUSION: Hyperandrogenemia and low SHBG in early and middle age associates with AGM independently of BMI.
Issue Date: 1-Nov-2021
Date of Acceptance: 17-Jun-2021
URI: http://hdl.handle.net/10044/1/90088
DOI: 10.1210/clinem/dgab456
ISSN: 0021-972X
Publisher: Endocrine Society
Start Page: e4621
End Page: e4633
Journal / Book Title: Journal of Clinical Endocrinology and Metabolism
Volume: 106
Issue: 11
Copyright Statement: © The Author(s) 2021. Published by Oxford University Press on behalf of the Endocrine Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Sponsor/Funder: MRC
Funder's Grant Number: G0802782
Keywords: Science & Technology
Life Sciences & Biomedicine
Obstetrics & Gynecology
Reproductive Biology
Abnormal glucose metabolism
free androgen index
insulin resistance
Abnormal glucose metabolism
free androgen index
insulin resistance
Obstetrics & Reproductive Medicine
11 Medical and Health Sciences
16 Studies in Human Society
Publication Status: Published
Conference Place: United States
Online Publication Date: 2021-06-21
Appears in Collections:Department of Metabolism, Digestion and Reproduction
Faculty of Medicine

This item is licensed under a Creative Commons License Creative Commons