Total but not bioavailable testosterone is a predictor of central adiposity in postmenopausal women.

OBJECTIVE

In pre and postmenopausal women low levels of sex hormone binding globulin (SHBG) have been shown to be associated with a large waist-hip ratio (WHR), a measure of visceral adiposity. Previous studies of WHR and testosterone, however, have been inconclusive.

DESIGN

We examined the prospective association between endogenous total and bioavailable testosterone and SHBG levels at baseline with WHR measured 12-15 years later in a community-based cohort of older women.

SETTING

Rancho Bernardo, California.

SUBJECTS

334 postmenopausal women.

MAIN OUTCOME MEASURES

Endogenous total and bioavailable testosterone and SHBG levels and WHR.

RESULTS

Only age-adjusted SHBG levels and the testosterone/SHBG ratio were associated with BMI. Age-adjusted SHBG levels and total testosterone decreased with increasing WHR. Neither measured nor estimated (testosterone/SHBG ratio) bioavailable testosterone was associated with WHR before or after adjustment for age, BMI, and cigarette smoking.

CONCLUSION

These prospective data confirm the reported cross-sectional association between SHBG and WHR, but show no association with measured bioavailable testosterone or the testosterone/SHBG ratio. These findings do not support the premise that androgens cause visceral adiposity in postmenopausal women.