| James Michael Howard 2005-11-29, 10:58 am |
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Metabolism. 2005 Dec;54(12):1626-31.
Does androgen excess contribute to the cardiovascular risk profile in
postmenopausal women with type 2 diabetes?
Korytkowski MT, Krug EI, Daly MA, Deriso L, Wilson JW, Winters SJ.
University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
The purpose of this study was to determine if postmenopausal women with
type 2 diabetes have clinical and biochemical evidence of androgen excess
as a potential contributor to an increase in risk for coronary heart
disease when compared with women without diabetes. Fasting glucose,
insulin, lipids, sex hormone-binding globulin (SHBG), and sex steroids
(from pooled samples) (total testosterone and free testosterone
[non-SHBG-T], androstenedione [A-dione], total estrogens) were measured at
baseline in 16 postmenopausal women with type 2 diabetes treated with diet
or a sulfonylurea and 17 age-matched controls. Measurements of glucose,
insulin, and sex steroids were repeated at hourly intervals for 3 hours
after oral glucose administration. Hirsutism scores and insulin sensitivity
(homeotasis model assessment [HOMA] insulin [SI]) were obtained. Women with
type 2 diabetes were more hyperglycemic, hyperinsulinemic, and
insulin-resistant (HOMA SI, 46.7 +/- 7.0 vs 12.9 +/- 2.0, P < .001), and
had higher total to high-density lipoprotein cholesterol (TC/HDL) ratios,
lower SHBG (20.8 +/- 3.5 vs 59.3 +/- 14.4 nmol/L, P < .05), higher
non-SHBG-T (0.225 +/- 0.025 vs 0.135 +/- 0.021 nmol/L, P < .05), and higher
hirsutism scores (1.1 +/- 0.3 vs 0.3 +/- 0.2, P = .004) than those without
diabetes. No changes in sex steroids occurred after the oral glucose
challenge. HOMA SI and area under the curve for glucose correlated
significantly with SHBG (r = -0.42), non-SHBG-T (r = 0.40), and TC/HDL (r =
0.41) (all P < .05) in the combined groups. Postmenopausal women with type
2 diabetes have both clinical and biochemical evidence of androgen excess
that may contribute to more adverse cardiovascular risk profiles.
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