Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/113409
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Type: Journal article
Title: 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
Author: Gyawali, P.
Martin, S.
Heilbronn, L.
Vincent, A.
Taylor, A.
Adams, R.
O Loughlin, P.
Wittert, G.
Citation: Acta Diabetologica, 2018; 55(8):861-872
Publisher: Springer
Issue Date: 2018
ISSN: 0940-5429
1432-5233
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Responsibility: 
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
Abstract: 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.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.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.In men, low TT, but not SHBG and other sex steroids, best predicts the development of T2D after adjustment for confounders.
Keywords: Men’s health; Sex hormone-binding globulin; Testosterone; Type 2 diabetes
Rights: © Springer-Verlag Italia S.r.l., part of Springer Nature 2018
RMID: 0030090184
DOI: 10.1007/s00592-018-1163-6
Grant ID: http://purl.org/au-research/grants/nhmrc/627227
Appears in Collections:Medicine publications

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