Consistent dose-response relationship between sex hormone levels and odds of metabolic syndrome in men across race and ethnic groups
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Portal hyperinsulinaemia secondary to whole-body insulin resistance decreases hepatic production of sex hormone binding globulin (SHBG), while expansion of fatty tissue increases aromatase activity and ensuing conversion of testosterone into estrogen, thereby promoting a hypogonadal-obesity self-reinforcing cycle. This population-based observational study aimed to investigate whether the association between sex hormone levels and metabolic syndrome varies by race and ethnic group in a random sample of 1885 men with complete data on total testosterone (T), free T and SHBG. Metabolic syndrome was defined by modified ATP III criteria. In both bivariate and multivariate analyses, a strong inverse association between hormone levels and metabolic syndrome was observed, the odds of metabolic syndrome increasing about twofold with a 1 standard deviation decrease in hormone levels. The association between sex hormones and metabolic syndrome was statistically significant across race and ethnic groups, with no significant between-group differences observed. The strength of the association between sex hormones and individual metabolic syndrome components varied, with stronger associations observed for waist circumference and dyslipidaemia and more modest associations for diabetes/elevated blood sugar. A robust, dose-response bidirectional relationship between sex hormone levels and odds of metabolic syndrome is consistent across race/ethnic groups.
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