Endogenous sex hormones and glucose tolerance status in postmenopausal women

J Clin Endocrinol Metab. 2007 Apr;92(4):1289-95. doi: 10.1210/jc.2006-1895. Epub 2007 Jan 23.


Context: In postmenopausal women, endogenous estradiol (E2) and free testosterone (T) have been positively associated with glucose intolerance and type 2 diabetes. Most studies have not examined these associations in a large group of postmenopausal women.

Objective: The objective was to examine the association between endogenous sex hormones and glucose tolerance in postmenopausal women.

Design, setting, and participants: This was a cross-sectional study of 1973 postmenopausal women ages 45-84 yr, not taking hormone replacement therapy, in the Multi-Ethnic Study of Atherosclerosis baseline examination.

Main outcome measures: Impaired fasting glucose (IFG) and diabetes were defined based on fasting blood sugar and/or treatment for diabetes. In women with normal glucose tolerance, insulin resistance was estimated using homeostasis model assessment of insulin resistance (HOMA-IR).

Results: Increasing quartiles of bioavailable T and E2 and decreasing quartiles of SHBG were associated with significantly increased odds of IFG and diabetes (all P for trend<0.001). Except for the association of bioavailable T with diabetes, the other associations persisted after multivariable adjustment. Although higher dehydroepiandrostenedione (DHEA) was associated with greater odds of IFG (P for trend=0.02), it was not associated with diabetes. Of 1100 women with normal glucose tolerance, E2 and DHEA were positively associated, and SHBG was inversely associated with HOMA-IR (all P<0.001) after multivariable adjustment. Bioavailable T was associated with HOMA-IR (P<0.001), but not fasting glucose.

Conclusion: Of postmenopausal women, endogenous bioavailable T, E2, and DHEA were positively associated and SHBG was negatively associated with insulin resistance.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Glucose / metabolism*
  • Body Mass Index
  • Body Size
  • Cross-Sectional Studies
  • Estradiol / blood*
  • Female
  • Glucose Intolerance / epidemiology*
  • Glucose Tolerance Test
  • Humans
  • Middle Aged
  • Postmenopause
  • Racial Groups
  • Testosterone / blood*


  • Blood Glucose
  • Testosterone
  • Estradiol