Testosterone, SHBG and risk of type 2 diabetes in the second evaluation of the Pizarra cohort study

Authors

  • Federico Soriguer,

    1. Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Malaga
    2. CIBERDEM CB07/08/0019 of the Instituto de Salud Carlos III, Madrid, Spain
    3. CIBER of the Pathophysiology of Obesity and Nutrition (CB06/03/0018) of the Instituto de Salud Carlos III, Madrid, Spain
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  • Elehazara Rubio-Martín,

    1. Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Malaga
    2. CIBERDEM CB07/08/0019 of the Instituto de Salud Carlos III, Madrid, Spain
    3. CIBER of the Pathophysiology of Obesity and Nutrition (CB06/03/0018) of the Instituto de Salud Carlos III, Madrid, Spain
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  • David Fernández,

    1. Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Malaga
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  • Sergio Valdés,

    1. Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Malaga
    2. CIBERDEM CB07/08/0019 of the Instituto de Salud Carlos III, Madrid, Spain
    3. CIBER of the Pathophysiology of Obesity and Nutrition (CB06/03/0018) of the Instituto de Salud Carlos III, Madrid, Spain
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  • Eva García-Escobar,

    1. Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Malaga
    2. CIBERDEM CB07/08/0019 of the Instituto de Salud Carlos III, Madrid, Spain
    3. CIBER of the Pathophysiology of Obesity and Nutrition (CB06/03/0018) of the Instituto de Salud Carlos III, Madrid, Spain
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  • Gracia M. Martín-Núñez,

    1. Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Malaga
    2. CIBERDEM CB07/08/0019 of the Instituto de Salud Carlos III, Madrid, Spain
    3. CIBER of the Pathophysiology of Obesity and Nutrition (CB06/03/0018) of the Instituto de Salud Carlos III, Madrid, Spain
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  • Isabel Esteva,

    1. Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Malaga
    2. CIBERDEM CB07/08/0019 of the Instituto de Salud Carlos III, Madrid, Spain
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  • Mari Cruz Almaraz,

    1. Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Malaga
    2. CIBERDEM CB07/08/0019 of the Instituto de Salud Carlos III, Madrid, Spain
    3. CIBER of the Pathophysiology of Obesity and Nutrition (CB06/03/0018) of the Instituto de Salud Carlos III, Madrid, Spain
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  • Gemma Rojo-Martínez

    1. Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Malaga
    2. CIBERDEM CB07/08/0019 of the Instituto de Salud Carlos III, Madrid, Spain
    3. CIBER of the Pathophysiology of Obesity and Nutrition (CB06/03/0018) of the Instituto de Salud Carlos III, Madrid, Spain
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Elehazara Rubio-Martín, Plaza Hospital Civil, Malaga CP 29009, Spain. Tel.: +34 951290346; fax: +34 952286704; e-mail: elehazara@gmail.com

Abstract

Eur J Clin Invest 2012; 42 (1): 79–85

Abstract

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.

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