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Associations Between Sex Steroids and the Development of Metabolic Syndrome: A Longitudinal Study in European Men

Antonio, Leen; Wu, Frederick C. W.; O'Neill, Terence W.; Pye, Stephen R.; Carter, Emma L.; Finn, Joseph D.; Rutter, Martin K.; Laurent, Michael R.; Huhtaniemi, Ilpo T. and Han, Thang S., et al. (2015) In Journal of Clinical Endocrinology and Metabolism 100(4). p.1396-1404
Abstract
Context: Low testosterone (T) has been associated with incident metabolic syndrome (MetS), but it remains unclear if this association is independent of sex hormone binding globulin (SHBG). Estradiol (E2) may also be associated with MetS, but few studies have investigated this. Objective: To study the association between baseline sex steroids and the development of incident MetS and to investigate the influence of SHBG, body mass index (BMI) and insulin resistance on this risk. Methods: Three thousand three hundred sixty nine community-dwelling men aged 40-79 years were recruited for participation in EMAS. MetS was defined by the updated NCEP ATP III criteria. Testosterone and E2 levels were measured by liquid and gas chromatography/mass... (More)
Context: Low testosterone (T) has been associated with incident metabolic syndrome (MetS), but it remains unclear if this association is independent of sex hormone binding globulin (SHBG). Estradiol (E2) may also be associated with MetS, but few studies have investigated this. Objective: To study the association between baseline sex steroids and the development of incident MetS and to investigate the influence of SHBG, body mass index (BMI) and insulin resistance on this risk. Methods: Three thousand three hundred sixty nine community-dwelling men aged 40-79 years were recruited for participation in EMAS. MetS was defined by the updated NCEP ATP III criteria. Testosterone and E2 levels were measured by liquid and gas chromatography/mass spectrometry, respectively. Logistic regression was used to assess the association between sex steroids and incident MetS. Results: One thousand six hundred fifty one men without MetS at baseline were identified. During follow-up, 289 men developed incident MetS, while 1362 men did not develop MetS. Men with lower baseline total T levels were at higher risk for developing MetS [odds ratio (OR) = 1.72, P < .001), even after adjustment for SHBG (OR = 1.43, P < .001), BMI (OR = 1.44, P < .001) or homeostasis model assessment of insulin resistance (HOMA-IR) (OR = 1.64, P < .001). E2 was not associated with development of MetS (OR = 1.04; P = .56). However, a lower E2/T ratio was associated with a lower risk of incident MetS (OR = 0.38; P < .001), even after adjustment for SHBG (OR = 0.48; P < .001), BMI (OR = 0.60; P = .001) or HOMA-IR (OR = 0.41; P < .001). Conclusions: Inmen, lower Tlevels, but not E2, are linked with an increased risk of developing MetS, independent of SHBG, BMI or insulin resistance. A lower E2/T ratio may be protective against developing MetS. (Less)
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Journal of Clinical Endocrinology and Metabolism
volume
100
issue
4
pages
1396 - 1404
publisher
The Endocrine Society
external identifiers
  • wos:000353361500046
  • scopus:84927648769
ISSN
1945-7197
DOI
10.1210/jc.2014-4184
language
English
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yes
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1e3d934d-2e90-457c-8f31-f627b4dc186d (old id 7439091)
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2015-07-03 07:09:20
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2017-11-19 03:49:29
@article{1e3d934d-2e90-457c-8f31-f627b4dc186d,
  abstract     = {Context: Low testosterone (T) has been associated with incident metabolic syndrome (MetS), but it remains unclear if this association is independent of sex hormone binding globulin (SHBG). Estradiol (E2) may also be associated with MetS, but few studies have investigated this. Objective: To study the association between baseline sex steroids and the development of incident MetS and to investigate the influence of SHBG, body mass index (BMI) and insulin resistance on this risk. Methods: Three thousand three hundred sixty nine community-dwelling men aged 40-79 years were recruited for participation in EMAS. MetS was defined by the updated NCEP ATP III criteria. Testosterone and E2 levels were measured by liquid and gas chromatography/mass spectrometry, respectively. Logistic regression was used to assess the association between sex steroids and incident MetS. Results: One thousand six hundred fifty one men without MetS at baseline were identified. During follow-up, 289 men developed incident MetS, while 1362 men did not develop MetS. Men with lower baseline total T levels were at higher risk for developing MetS [odds ratio (OR) = 1.72, P &lt; .001), even after adjustment for SHBG (OR = 1.43, P &lt; .001), BMI (OR = 1.44, P &lt; .001) or homeostasis model assessment of insulin resistance (HOMA-IR) (OR = 1.64, P &lt; .001). E2 was not associated with development of MetS (OR = 1.04; P = .56). However, a lower E2/T ratio was associated with a lower risk of incident MetS (OR = 0.38; P &lt; .001), even after adjustment for SHBG (OR = 0.48; P &lt; .001), BMI (OR = 0.60; P = .001) or HOMA-IR (OR = 0.41; P &lt; .001). Conclusions: Inmen, lower Tlevels, but not E2, are linked with an increased risk of developing MetS, independent of SHBG, BMI or insulin resistance. A lower E2/T ratio may be protective against developing MetS.},
  author       = {Antonio, Leen and Wu, Frederick C. W. and O'Neill, Terence W. and Pye, Stephen R. and Carter, Emma L. and Finn, Joseph D. and Rutter, Martin K. and Laurent, Michael R. and Huhtaniemi, Ilpo T. and Han, Thang S. and Lean, Michael E. J. and Keevil, Brian G. and Pendleton, Neil and Rastrelli, Giulia and Forti, Gianni and Bartfai, Gyorgy and Casanueva, Felipe F. and Kula, Krzysztof and Punab, Margus and Giwercman, Aleksander and Claessens, Frank and Decallonne, Brigitte and Vanderschueren, Dirk},
  issn         = {1945-7197},
  language     = {eng},
  number       = {4},
  pages        = {1396--1404},
  publisher    = {The Endocrine Society},
  series       = {Journal of Clinical Endocrinology and Metabolism},
  title        = {Associations Between Sex Steroids and the Development of Metabolic Syndrome: A Longitudinal Study in European Men},
  url          = {http://dx.doi.org/10.1210/jc.2014-4184},
  volume       = {100},
  year         = {2015},
}