Testosterone, SHBG and risk of type 2 diabetes in the second evaluation of the Pizarra cohort study
Article first published online: 16 JUN 2011
© 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation
European Journal of Clinical Investigation
Volume 42, Issue 1, pages 79–85, January 2012
How to Cite
Soriguer, F., Rubio-Martín, E., Fernández, D., Valdés, S., García-Escobar, E., Martín-Núñez, G. M., Esteva, I., Almaraz, M. C. and Rojo-Martínez, G. (2012), Testosterone, SHBG and risk of type 2 diabetes in the second evaluation of the Pizarra cohort study. European Journal of Clinical Investigation, 42: 79–85. doi: 10.1111/j.1365-2362.2011.02559.x
- Issue published online: 7 DEC 2011
- Article first published online: 16 JUN 2011
- Accepted manuscript online: 23 MAY 2011 11:25AM EST
- Received 13 January 2011; accepted 20 May 2011
- Bioavailable testosterone;
- diabetes mellitus;
- Pizarra study;
- prospective study;
- sex hormone-binding globulin;
Eur J Clin Invest 2012; 42 (1): 79–85
Aim To evaluate the association between serum levels of testosterone, sex hormone-binding globulin (SHBG) and calculated bioavailable testosterone (bioT), and the risk of type 2 diabetes mellitus (T2D) in a prospective cohort from southern Spain (Pizarra study).
Research design and methods The study was performed in the Pizarra Cohort Study, a prospective study started in 1995 with a follow-up of 11 years. Anthropometric and metabolic variables were measured at baseline and at 6 and 11 years of follow-up. Total testosterone (TT), SHBG and calculated bioT were determined at the 6-year follow-up.
Results The levels of TT and bioT in men were negatively associated with the risk of obesity, T2D and the metabolic syndrome. In women, the levels of TT and bioT were associated positively with the risk of insulin resistance. The levels of SHBG were associated negatively with the risk of T2D, obesity and insulin resistance in both men and women. For all groups, the association was higher at the 11-year follow-up.
Conclusions Low levels of testosterone and SHBG increase the risk of T2D in men, and high levels of testosterone increase the risk of insulin resistance in women. The association between TT levels and the risk of T2D is not completely independent of other variables, such as exposure time, adiposity, insulin resistance or SHBG levels. This study also shows that the different responses between men and women are probably because of the protective effect of SHBG, levels of which are higher in women than in men.