Changes in Visceral Adiposity, Subcutaneous Adiposity, and Sex Hormones in the Diabetes Prevention Program

J Clin Endocrinol Metab. 2017 Sep 1;102(9):3381-3389. doi: 10.1210/jc.2017-00967.


Context: The degree to which changes in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) relate to corresponding changes in plasma sex steroids is not known.

Objective: We examined whether changes in VAT and SAT areas assessed by computed tomography were associated with changes in sex hormones [dehydroepiandrosterone sulfate (DHEAS), testosterone, estradiol, estrone, and sex hormone binding globulin (SHBG)] among Diabetes Prevention Program participants.

Design: Secondary analysis of a randomized trial.

Participants: Overweight and glucose-intolerant men (n = 246) and women (n = 309).

Interventions: Intensive lifestyle change with goals of weight reduction and 150 min/wk of moderate intensity exercise or metformin administered 850 mg twice a day or placebo.

Main outcome measures: Associations between changes in VAT, SAT, and sex hormone changes over 1 year.

Results: Among men, reductions in VAT and SAT were both independently associated with significant increases in total testosterone and SHBG in fully adjusted models. Among women, reductions in VAT and SAT were both independently associated with increases in SHBG and associations with estrone differed by menopausal status. Associations were similar by race/ethnicity and by randomization arm. No significant associations were observed between change in fat depot with change in estradiol or DHEAS.

Conclusions: Among overweight adults with impaired glucose intolerance, reductions in either VAT and SAT were associated with increased total testosterone in men and higher SHBG in men and women. Weight loss may affect sex hormone profiles via reductions in visceral and subcutaneous fat.

Trial registration: NCT00038727.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / prevention & control*
  • Estradiol / blood
  • Female
  • Glucose Intolerance / diagnosis*
  • Gonadal Steroid Hormones / metabolism*
  • Humans
  • Intra-Abdominal Fat / metabolism*
  • Life Style
  • Linear Models
  • Male
  • Metformin / administration & dosage*
  • Middle Aged
  • Obesity / metabolism
  • Primary Prevention / organization & administration
  • Program Evaluation
  • Risk Assessment
  • Statistics, Nonparametric
  • Subcutaneous Fat / metabolism*
  • Testosterone / blood


  • Blood Glucose
  • Gonadal Steroid Hormones
  • Testosterone
  • Estradiol
  • Metformin

Associated data