TY - JOUR
T1 - Androgens, Irregular menses, and risk of diabetes and coronary artery calcification in the diabetes prevention program
AU - Kim, Catherine
AU - Aroda, Vanita R.
AU - Goldberg, Ronald B.
AU - Younes, Naji
AU - Edelstein, Sharon L.
AU - Carrion-Petersen, Mary Lou
AU - Ehrmann, David A.
N1 - Funding Information:
Financial Support: This study was supported by Grants DK072041, DK048489, and DK53061 from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health, which provided funding to the clinical centers and the Coordinating Center for the design and conduct of the study and the collection, management, analysis, and interpretation of the data. The Southwestern American Indian Centers were supported directly by NIDDK, including its Intramural Research Program, and the Indian Health Service. The General Clinical Research Center Program, National Center for Research Resources, and the Department of Veterans Affairs supported data collection at many of the clinical centers. Funding was also provided by the National Institute of Child Health and Human Development, National Institute on Aging, National Eye Institute, National Heart, Lung, and Blood Institute, Office of Research on Women’s Health, National Institute on Minority Health and Health Disparities, Centers for Disease Control and Prevention, and American Diabetes Association. Bristol-Myers Squibb and Parke-Davis provided additional funding and material support during DPP, Lipha (Merck-Sante) provided medication, and LifeScan Inc. donated materials during DPP and DPPOS. The opinions expressed herein are those of the investigators and do not necessarily reflect the views of the funding agencies. A complete list of centers, investigators, and staff can be found in the online appendix. The research group gratefully acknowledges the commitment and dedication of the participants of the DPP and DPPOS.
Publisher Copyright:
Copyright © 2018 Endocrine Society.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Context: It is unclear whether relative elevations in androgens or irregular menses (IM) are associated with greater cardiometabolic risk among women who are already overweight and glucose intolerant. Research Design and Methods: We conducted a secondary analysis of the Diabetes Prevention Program (DPP) and the Diabetes Prevention Program Outcomes Study (DPPOS). Participants included womenwith sex hormone measurements who did not use exogenous estrogen (n = 1422).We examined whether free androgen index (FAI) or IMwas associated with diabetes risk during theDPP/DPPOS orwith coronary artery calcification (CAC) at DPPOS year 10. Models were adjusted for menopausal status, age, race or ethnicity, randomization arm, body mass index (BMI), and hemoglobin A1c. Results: Women had an average age of 48.2 6 9.9 years. Elevations in FAI and IM were associated with greater BMI, waist circumference, and blood pressure and lower adiponectin. FAI was not associated with diabetes risk during the DPP/DPPOS [hazard ratio (HR) 0.97; 95% confidence interval (CI), 0.93 to 1.02] or increased odds of CAC [odds ratio (OR) 1.06;95%CI, 0.92 to 1.23]. IM was also not associated with diabetes risk during the DPP/DPPOS (HR 1.07; 95% CI, 0.87 to 1.31) or increased odds of CAC (OR 0.89; 95% CI, 0.53 to 1.49). Women who had both relative elevations in FAI and IM had similar diabetes risk and odds of CAC as women without these conditions. Differences by treatment arm and menopausal status were not observed. Conclusions: Among midlife women who were already glucose intolerant and overweight, androgen concentrations and IM did not additionally contribute to increased risk for diabetes or CAC.
AB - Context: It is unclear whether relative elevations in androgens or irregular menses (IM) are associated with greater cardiometabolic risk among women who are already overweight and glucose intolerant. Research Design and Methods: We conducted a secondary analysis of the Diabetes Prevention Program (DPP) and the Diabetes Prevention Program Outcomes Study (DPPOS). Participants included womenwith sex hormone measurements who did not use exogenous estrogen (n = 1422).We examined whether free androgen index (FAI) or IMwas associated with diabetes risk during theDPP/DPPOS orwith coronary artery calcification (CAC) at DPPOS year 10. Models were adjusted for menopausal status, age, race or ethnicity, randomization arm, body mass index (BMI), and hemoglobin A1c. Results: Women had an average age of 48.2 6 9.9 years. Elevations in FAI and IM were associated with greater BMI, waist circumference, and blood pressure and lower adiponectin. FAI was not associated with diabetes risk during the DPP/DPPOS [hazard ratio (HR) 0.97; 95% confidence interval (CI), 0.93 to 1.02] or increased odds of CAC [odds ratio (OR) 1.06;95%CI, 0.92 to 1.23]. IM was also not associated with diabetes risk during the DPP/DPPOS (HR 1.07; 95% CI, 0.87 to 1.31) or increased odds of CAC (OR 0.89; 95% CI, 0.53 to 1.49). Women who had both relative elevations in FAI and IM had similar diabetes risk and odds of CAC as women without these conditions. Differences by treatment arm and menopausal status were not observed. Conclusions: Among midlife women who were already glucose intolerant and overweight, androgen concentrations and IM did not additionally contribute to increased risk for diabetes or CAC.
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U2 - 10.1210/jc.2017-01829
DO - 10.1210/jc.2017-01829
M3 - Article
C2 - 29220533
AN - SCOPUS:85041902826
VL - 103
SP - 486
EP - 496
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 2
ER -