Article ; Online: Longitudinal Changes in Sex Hormone Binding Globulin (SHBG) and Risk of Incident Diabetes: The Study of Women's Health Across the Nation (SWAN).
2024 Volume 47, Issue 4, Page(s) 676–682
Abstract: Objective: To investigate the associations of longitudinal changes in sex hormone binding globulin (SHBG) and testosterone (T) over the menopause transition with the risk of diabetes.: Research design and methods: We followed 2,952 participants in ... ...
| Abstract | Objective: To investigate the associations of longitudinal changes in sex hormone binding globulin (SHBG) and testosterone (T) over the menopause transition with the risk of diabetes. Research design and methods: We followed 2,952 participants in the Study of Women's Health Across the Nation (SWAN) who were premenopausal or early perimenopausal and diabetes-free at baseline. SHBG,T, and estradiol (E2) levels were measured at up to 13 follow-up visits (over up to 17 years). We used complementary log-log-based discrete-time survival models anchored at baseline. Results: Diabetes developed in 376 women. A 5-unit increase in time-varying SHBG was associated with a 10% reduced risk of diabetes (hazard ratio [HR] 0.91, 95% CI 0.87-0.95), adjusting for covariates, and baseline SHBG,T, and E2 levels. Time-varying T was not associated with diabetes risk. Compared with the lowest quartile for annual rate of change of SHBG since baseline (quartile 1 [Q1] -92.3 to -1.5 nmol/L), all other quartiles were associated with a decreased risk of diabetes adjusting for covariates and baseline SHBG; associations persisted after adjusting for rate of change of T and E2 (Q2 [> -1.5 to -0.2 nmol/L] HR 0.33, 95% CI 0.23-0.48; Q3 [> -0.2 to 1.3 nmol/L] HR 0.37, 95% CI 0.25-0.55; Q4 [>1.3 to 82.0 nmol/L] HR 0.43, 95% CI 0.30-0.63). Conclusions: Increasing levels of SHBG over the menopause transition were associated with a decreased risk of incident diabetes. Stable to increasing rates of change in SHBG were also independently associated with a decreased risk of diabetes compared with decreasing rates of change, suggesting SHBG may affect glucose through a mechanism beyond androgenicity. |
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| MeSH term(s) | Female ; Humans ; Diabetes Mellitus/epidemiology ; Estradiol ; Menopause ; Sex Hormone-Binding Globulin/metabolism ; Testosterone ; Women's Health |
| Chemical Substances | Estradiol (4TI98Z838E) ; Sex Hormone-Binding Globulin ; Testosterone (3XMK78S47O) ; SHBG protein, human |
| Language | English |
| Publishing date | 2024-02-07 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 441231-x |
| ISSN | 1935-5548 ; 0149-5992 |
| ISSN (online) | 1935-5548 |
| ISSN | 0149-5992 |
| DOI | 10.2337/dc23-1630 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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