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

2009/10/21 by Shrita M. Patel, Sarah J. Ratcliffe, Muredach P. Reilly +9 · 131 citations
Medicine · Psychology · #Abdominal obesity #Confidence interval #Endocrinology #Evolutionary Psychology and Human Behavior #Glucose homeostasis #Hormonal and reproductive studies #Insulin #Insulin resistance #Internal medicine #Medicine #Menopause: Health Impacts and Treatments #Metabolic syndrome #Obesity #Odds ratio #Quartile

paper · open access · doi:10.1210/jc.2009-0740

published in The Journal of Clinical Endocrinology & Metabolism 94(12), 4776-4784 (Oxford University Press)

openalex publication_date 2009/10/21 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01

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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