Cited by 132Hormonal and reproductive studiesDiabetes, Cardiovascular Risks, and LipoproteinsMenopause: Health Impacts and Treatments

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Higher Serum Testosterone Concentration in Older Women is Associated with Insulin Resistance, Metabolic Syndrome, and Cardiovascular Disease

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Patel, Shrita M., Ratcliffe, Sarah J., Reilly, Muredach P., Weinstein, Rachel, Bhasin, Shalender, Blackman, Marc R., Cauley, Jane A., Sutton-Tyrrell, Kim, Robbins, John, Fried, Linda P., Cappola, Anne R.·2009·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jc.2009-0740PMC PMC2795656

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Abstract

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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Withdrawn: Postmenopausal Women with a History of Irregular Menses and Elevated Androgen Measurements at High Risk for Worsening Cardiovascular Event-Free Survival: Results from the National Institutes of Health—National Heart, Lung, and Blood Institute Sponsored Women’s Ischemia Syndrome Evaluation
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Retracted
Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge
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Detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III)
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“Insulin resistance was assessed via calculation of homeostasis model assessment insulin resistance (HOMA-IR): (fasting glucose in milligrams per deciliter insulin in microunits per milliliter)/405 (26) and insulin sensitivity by calculation of the Quantitative Insulin Sensitivity Check Index (QUICKI): 1/(log[fasting g…”
Method
Heart Disease and Stroke Statistics—2008 Update
Writing Group Members, Rosamond, W. D., Flegal, K. M., Furie, K. L., Go, A. S., Greenlund, K. J., Haase, N., Hailpern, S. M., Ho, M., Howard, V. J., et al. (2007) · Circulation · doi:10.1161/circulationaha.107.187998 · Cited by 3,799

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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: Ratcliffe, Sarah J.
Reilly, Muredach P.
Weinstein, Rachel
Bhasin, Shalender
Cauley, Jane A.
Fried, Linda P.
Cappola, Anne R.
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
DOI: 10.1210/jc.2009-0740
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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Higher Serum Testosterone Concentration in Older Women is Associated with Insulin Resistance, Metabolic Syndrome, and Cardiovascular Disease

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