Higher serum testosterone concentration in older women is associated with insulin resistance, metabolic syndrome, and cardiovascular disease
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CONTEXT: Early postmenopausal women with higher testosterone (T) levels have increased insulin resistance (IR) and cardiovascular risk factors, but whether this translates into increased cardiovascular disease later in life is unknown. OBJECTIVE: The objective of the study was to determine whether higher T levels are associated with IR, the metabolic syndrome (MetSyn), and coronary heart disease (CHD) in elderly women. DESIGN: Total T and free T by equilibrium dialysis were measured using ultrasensitive assays in 344 women aged 65-98 yr enrolled in the Cardiovascular Health Study. Cross-sectional analyses were performed to examine the associations between total and free T and IR, MetSyn, and CHD. RESULTS: There was a stepwise increase in the homeostasis model assessment of insulin resistance with increasing total (P = 0.0.003) and free T (P = 0.02) level and a corresponding decrease in Quantitative Insulin Sensitivity Check Index (P < 0.001 and P = 0.002, respectively). In adjusted models, higher levels of both total and free T were strongly associated with abdominal obesity and high fasting glucose, the two MetSyn components most strongly linked to IR. After adjustment, women in the top quartile of total T levels had a 3-fold greater odds of MetSyn (odds ratio 3.15, 95% confidence interval 1.57-6.35) than those in the bottom quartile and a 3-fold greater odds of CHD (odds ratio 2.95, 95% confidence interval 1.2-7.3) than those in second quartile, whereas free T was not significantly associated with MetSyn or CHD. CONCLUSIONS: Higher levels of T are associated with IR, MetSyn, and CHD in elderly women. Whether T is a marker or mediator of cardiovascular disease in this population merits further investigation.
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In elderly men, lower testosterone levels are associated with reduced insulin sensitivity as indicated by higher glucose during an oral glucose tolerance test, reduced QUICKI score, and lower HOMA-IR values.
“In elderly men, lower T levels are associated with reduced insulin sensitivity as indicated by higher glucose levels during an oral glucose tolerance test,71 reduced quantitative insulin sensitivity check index score,93, 94 and lower HOMA-IR values.95”
From Hormonal and Metabolic Changes of Aging and the Influence of Lifestyle Modifications (2021) · cites this paper as [94]
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- Authors
- Patel, S. M., Ratcliffe, S. J., Reilly, M. P., Weinstein, R., Bhasin, S., Blackman, M. R., Cauley, J. A., Sutton-Tyrrell, K., Robbins, J., Fried, L. P., & Cappola, A. R.
- Affiliations
- University of Pennsylvania (US)
- Boston University (US)
- United States Department of Veterans Affairs (US)
- University of Pittsburgh (US)
- University of California Davis Medical Center (US)
- Columbia University (US)
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2009-12-01
- Volume
- 94
- Issue
- 12
- Pages
- 4776-4784
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC2795656
- OpenAlex
- W2085980021
- Cited by
- 132
- References
- 48
- Citations by year
- 2026: 8 · 2025: 3 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 8 · 2020: 4 · 2019: 8 · 2018: 10 · 2017: 7 · 2016: 12 · 2015: 9 · 2014: 7 · 2013: 11 · 2012: 17
- FWCI
- 8.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- John A. Hartford Foundation
- Hartford Foundation for Public Giving
- Pfizer
- University of Pennsylvania
- National Institutes of Health (n01hc085082-026, n01hc085081-021, n01hc085079-024, n01hc015103-009, n01hc085084-005, n01hc085085-011, n01hc085083-027, n01hc085080-026, n01hc085086-022, n01hc035129-010)
- National Institute on Aging (N01HC85079, N01 HC‐15103, N01‐HC‐35129, K23AG19161, N01‐HC‐85086, K23AG019161)
- National Heart, Lung, and Blood Institute (N01-HC-85081, N01HC85085, N01 HC085086, N01HC-85083, N01HC15103, N01 HC085079, N01HC85082, N01 HC85086, N01 HC035129, N01HC85080, N01 HC015103, N01-HC-85079 through N01-HC-85086, N01-HC85079, N01-HC85084, N01HC35129)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- serum testosterone, free testosterone, insulin resistance, metabolic syndrome, coronary artery disease, cardiovascular disease, older women, abdominal obesity, fasting blood glucose, postmenopausal women, Cardiovascular Health Study
- MeSH terms
- Aged, Aged, 80 and over, Blood Glucose, Cardiovascular Diseases, Coronary Disease, Female, Humans, Insulin, Insulin Resistance, Radioimmunoassay, Socioeconomic Factors, Testosterone, Odds Ratio, Treatment Outcome, Metabolic Syndrome
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