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Serum testosterone, sex hormone-binding globulin and sex-specific risk of incident type 2 diabetes in a retrospective primary care cohort

Show simple item record O'Reilly, M. W. en Glisic, M. en Kumarendran, B. en Subramanian, A. en_US Manolopoulos, K. N. en Tahrani, A. A. en Keerthy, D. en Muka, T. en_US Toulis, K. A. en_US Hanif, W. en Thomas, G. N. en Franco, O. H. en_US Arlt, W. en_US Nirantharakumar, K. en_US 2019-01-03T05:39:43Z en_US 2019-01-03T05:39:43Z en 2019 en_US
dc.identifier.citation Clinical Endocrinology. 2019; 90(1): 45-154 en_US
dc.identifier.issn 0300-0664 (Print) en_US
dc.identifier.issn 1365-2265 (Electronic) en_US
dc.identifier.uri en_US
dc.description Indexed in MEDLINE. en_US
dc.description.abstract OBJECTIVE: Previous studies suggest that androgens have a sexually dimorphic impact on metabolic dysfunction. However, the sex-specific link between circulating androgens and risk of type 2 diabetes mellitus (T2DM) has not been examined in a large scale, longitudinal cohort, a task we undertook in this study. DESIGN: A retrospective cohort study in a UK primary care database. PATIENTS: We included men and women with available serum testosterone and sex hormone-binding globulin (SHBG) results. MEASUREMENTS: We categorized serum concentrations according to clinically relevant cut-off points and calculated crude and adjusted T2DM Incidence Rate Ratios (IRRs and aIRRs). RESULTS: Serum testosterone concentrations were available in 70 541 men and 81 889 women; serum SHBG was available in 15 907 men and 42 034 women. In comparison to a reference cohort with serum testosterone ≥20 nmol/L, men with lower serum testosterone had a significantly increased risk of T2DM, with the highest risk in those with serum testosterone <7 nmol/L (aIRR 2.71, 95% CI 2.34-3.14, P < 0.001). In women, the risk of T2DM started to increase significantly when serum testosterone concentrations exceeded 1.5 nmol/L, with the highest risk in women with serum testosterone ≥3.5 nmol/L (aIRR 1.98, 95% CI 1.55-2.52, P < 0.001). These observations were verified in a continuous rather than categorized analysis. The risk of T2DM increased in men and women with serum SHBG <40 and <50 nmol/L, respectively. CONCLUSIONS/INTERPRETATION: In this longitudinal study, we found sexually dimorphic associations between serum testosterone and risk of incident T2DM. Androgen deficiency and excess should be considered important risk factors for diabetes in men and women, respectively. en_US
dc.language.iso en en_US
dc.publisher Blackwell Scientific Publications en_US
dc.subject Testosterone en_US
dc.title Serum testosterone, sex hormone-binding globulin and sex-specific risk of incident type 2 diabetes in a retrospective primary care cohort en_US
dc.type Article en_US

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