Departments of Medicine, Obstetrics & Gynecology, and Epidemiology, University of Michigan, Ann Arbor, Michigan.
MedStar Health Research Institute, Hyattsville, Maryland.
J Clin Endocrinol Metab. 2018 Feb 1;103(2):486-496. doi: 10.1210/jc.2017-01829.
It is unclear whether relative elevations in androgens or irregular menses (IM) are associated with greater cardiometabolic risk among women who are already overweight and glucose intolerant.
We conducted a secondary analysis of the Diabetes Prevention Program (DPP) and the Diabetes Prevention Program Outcomes Study (DPPOS). Participants included women with sex hormone measurements who did not use exogenous estrogen (n = 1422). We examined whether free androgen index (FAI) or IM was associated with diabetes risk during the DPP/DPPOS or with coronary artery calcification (CAC) at DPPOS year 10. Models were adjusted for menopausal status, age, race or ethnicity, randomization arm, body mass index (BMI), and hemoglobin A1c.
Women had an average age of 48.2 ± 9.9 years. Elevations in FAI and IM were associated with greater BMI, waist circumference, and blood pressure and lower adiponectin. FAI was not associated with diabetes risk during the DPP/DPPOS [hazard ratio (HR) 0.97; 95% confidence interval (CI), 0.93 to 1.02] or increased odds of CAC [odds ratio (OR) 1.06; 95% CI, 0.92 to 1.23]. IM was also not associated with diabetes risk during the DPP/DPPOS (HR 1.07; 95% CI, 0.87 to 1.31) or increased odds of CAC (OR 0.89; 95% CI, 0.53 to 1.49). Women who had both relative elevations in FAI and IM had similar diabetes risk and odds of CAC as women without these conditions. Differences by treatment arm and menopausal status were not observed.
Among midlife women who were already glucose intolerant and overweight, androgen concentrations and IM did not additionally contribute to increased risk for diabetes or CAC.
目前尚不清楚在已经超重和葡萄糖耐量受损的女性中，雄激素水平的相对升高或月经不规律（IM）是否与更大的心血管代谢风险相关。
我们对糖尿病预防计划（DPP）和糖尿病预防计划结果研究（DPPOS）进行了二次分析。参与者包括未使用外源性雌激素的有性激素测量值的女性（n=1422）。我们研究了游离雄激素指数（FAI）或 IM 是否与 DPP/DPPOS 期间的糖尿病风险相关，或与 DPPOS 第 10 年的冠状动脉钙化（CAC）相关。模型调整了绝经状态、年龄、种族或民族、随机分组、体重指数（BMI）和糖化血红蛋白（HbA1c）。
女性的平均年龄为 48.2±9.9 岁。FAI 和 IM 的升高与更高的 BMI、腰围和血压以及更低的脂联素相关。FAI 与 DPP/DPPOS 期间的糖尿病风险无关[风险比（HR）0.97；95%置信区间（CI），0.93 至 1.02]或 CAC 增加的几率[比值比（OR）1.06；95%CI，0.92 至 1.23]。IM 与 DPP/DPPOS 期间的糖尿病风险也无关（HR 1.07；95%CI，0.87 至 1.31）或 CAC 增加的几率（OR 0.89；95%CI，0.53 至 1.49）。同时存在 FAI 和 IM 相对升高的女性与无这些情况的女性的糖尿病风险和 CAC 几率相似。未观察到治疗组和绝经状态的差异。
在已经葡萄糖耐量受损和超重的中年女性中，雄激素浓度和 IM 并没有额外增加患糖尿病或 CAC 的风险。
