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29.05.2018 | Original Article

The role of sex hormone-binding globulin (SHBG), testosterone, and other sex steroids, on the development of type 2 diabetes in a cohort of community-dwelling middle-aged to elderly men

verfasst von: Prabin Gyawali, Sean A. Martin, Leonie K. Heilbronn, Andrew D. Vincent, Anne W. Taylor, Robert J. T. Adams, Peter D. O’Loughlin, Gary A. Wittert

Erschienen in: Acta Diabetologica | Ausgabe 8/2018

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Abstract

Aims

Contrasting findings exist regarding the association between circulating sex hormone-binding globulin (SHBG) and testosterone levels and type 2 diabetes (T2D) in men. We examined prospective associations of SHBG and sex steroids with incident T2D in a cohort of community-dwelling men.

Methods

Participants were from a cohort study of community-dwelling (n = 2563), middle-aged to elderly men (35–80 years) from Adelaide, Australia (the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study). The current study included men who were followed for 5 years and with complete SHBG and sex steroid levels (total testosterone (TT), dihydrotestosterone (DHT) and oestradiol (E2)), but without T2D at baseline (n = 1597). T2D was identified by either self-report, fasting glucose (≥ 7.0 mmol/L), HbA1c (≥ 6.5%/48.0 mmol/mol), and/or prescriptions for diabetes medications. Logistic binomial regression was used to assess associations between SHBG, sex steroids and incident T2D, adjusting for confounders including age, smoking status, physical activity, adiposity, glucose, triglycerides, symptomatic depression, SHBG and sex steroid levels.

Results

During an average follow-up of 4.95 years, 14.5% (n = 232) of men developed new T2D. Multi-adjusted models revealed an inverse association between baseline SHBG, TT, and DHT levels, and incident T2D (odds ratio (OR) = 0.77, 95% CI [0.62, 0.95], p = 0.02; OR 0.70 [0.57, 0.85], p < 0.001 and OR 0.78 [0.63, 0.96], p = 0.02), respectively. However, SHBG was no longer associated with incident T2D after additional adjustment for TT (OR 0.92 [0.71, 1.17], p = 0.48; TT in incident T2D: OR 0.73 [0.57, 0.92], p = 0.01) and after separate adjustment for DHT (OR 0.83 [0.64, 1.08], p = 0.16; DHT in incident T2D: OR 0.83 [0.65, 1.05], p = 0.13). There was no observed effect of E2 in all models of incident T2D.

Conclusions

In men, low TT, but not SHBG and other sex steroids, best predicts the development of T2D after adjustment for confounders.

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Titel: The role of sex hormone-binding globulin (SHBG), testosterone, and other sex steroids, on the development of type 2 diabetes in a cohort of community-dwelling middle-aged to elderly men
verfasst von: Prabin Gyawali
Sean A. Martin
Leonie K. Heilbronn
Andrew D. Vincent
Anne W. Taylor
Robert J. T. Adams
Peter D. O’Loughlin
Gary A. Wittert
Publikationsdatum: 29.05.2018
Verlag: Springer Milan
Erschienen in: Acta Diabetologica / Ausgabe 8/2018
Print ISSN: 0940-5429
Elektronische ISSN: 1432-5233
DOI: https://doi.org/10.1007/s00592-018-1163-6

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