Androgenicity in Young Women and Development of Metabolic Syndrome Before Menopause: The CARDIA and CARDIA Women's Studies

Thanh-Huyen T Vu; Amber Pirzada; Cora E Lewis; Pamela J Schreiner; Kiang Liu; Barbara Sternfeld; Ronit Calderon-Margalit; Sharon S Merkin; Melissa Wellons; O Dale Williams; Catherine Kim; David S Siscovick; Martha L Daviglus

doi:10.1210/jendso/bvad174

Androgenicity in Young Women and Development of Metabolic Syndrome Before Menopause: The CARDIA and CARDIA Women's Studies

J Endocr Soc. 2023 Dec 28;8(2):bvad174. doi: 10.1210/jendso/bvad174. eCollection 2024 Jan 5.

Authors

Thanh-Huyen T Vu¹, Amber Pirzada², Cora E Lewis^{3

4}, Pamela J Schreiner⁵, Kiang Liu¹, Barbara Sternfeld⁶, Ronit Calderon-Margalit⁷, Sharon S Merkin⁸, Melissa Wellons⁹, O Dale Williams¹⁰, Catherine Kim¹¹, David S Siscovick^{12

13

14}, Martha L Daviglus^{1

2}

Affiliations

¹ Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.
² Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL 60612, USA.
³ Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
⁴ Diabetes Research and Training Center School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
⁵ Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454, USA.
⁶ Division of Research, Kaiser Permanente, Oakland, CA 94612, USA.
⁷ Hebrew University-Hadassah Braun School of Public Health and Social Medicine, Jerusalem 91120, Israel.
⁸ Division of Geriatrics, Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.
⁹ Division of Diabetes, Endocrinology, & Metabolism, Vanderbilt Eskind Diabetes Clinic, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
¹⁰ Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33174, USA.
¹¹ Medical School and School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
¹² New York Academy of Medicine, New York, NY 10029, USA.
¹³ Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA 98195, USA.
¹⁴ Department of Epidemiology, University of Washington, Seattle, WA 98195, USA.

Abstract

Context: There are no reported data from prospective long-term studies on the relation of androgen levels in young women with development of metabolic syndrome (MetS) before menopause.

Objective: We investigated associations of androgens and SHBG with incident MetS during 23 years of follow-up.

Methods: We included 366 White and 375 Black women ages 20 to 32 years participating in the CARDIA study and CARDIA Women's study, free of MetS at baseline examination (1987-1988), and premenopausal 23 years later. Androgens and SHBG were categorized into quartiles. MetS was defined according to the American Heart Association/National Heart, Lung, and Blood Institute 2009 Joint Scientific Statement. Cox proportional hazards models were used.

Results: By year 23, 30% of women developed MetS. Adjusting for baseline age, race, and education, hazard ratios (95% CI) of developing MetS were 1.46 (1.02-2.10) and 2.22 (1.53-3.21) for women in the highest vs lowest total testosterone (T) and free T quartile, respectively. The hazards of developing MetS were 47%, 59%, and 53% lower for women with SHBG in the second, third, and fourth quartiles (vs lowest quartile), respectively. Associations were attenuated for total T with further adjustments for smoking, physical activity, menstrual status, oral contraceptive/hormone (OCHM) use, insulin level, oligomenorrhea, and age at menarche, but remained statistically significant for free T and SHBG. Associations were similar for both Blacks and Whites, and OCHM nonusers, but not for OCHM users.

Conclusion: High androgenicity in young premenopausal women is associated with higher risk of future MetS, suggesting that early assessment of androgens may contribute to prevention.

Keywords: free testosterone; metabolic syndrome; pre-menopause; prospective study; sex hormone binding globulin; total testosterone.

Abstract

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