Sex hormone-binding globulin and risk of clinical diabetes in American black, Hispanic, andAsian/Pacific islander postmenopausal women

Brian H. Chen, Kathleen Brennan, Atsushi Goto, Yiqing Song, Najib Aziz, Nai Chieh Y. You, Melissa F. Wellons, Jo Ann E. Manson, Donna L. White, Anthony W. Butch, Simin Liu

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Abstract

BACKGROUND: Recent prospective studies have shown a strong inverse association between sex hormone-binding globulin (SHBG) concentrations and risk of clinical diabetes in white individuals. However, it remains unclear whether this relationship extends to other racial/ethnic populations. METHODS: We evaluated the association between baseline concentrations of SHBG and clinical diabetes risk in the Women's Health Initiative Observational Study. Over a median follow-up of 5.9 years, we identified 642 postmenopausal women who developed clinical diabetes (380 blacks, 157 Hispanics, 105 Asians) and 1286 matched controls (777 blacks, 307 Hispanics, 202 Asians). RESULTS: Higher concentrations of SHBG at baseline were associated with a significantly lower risk of clinical diabetes [relative risk (RR), 0.15; 95% CI, 0.09-0.26 for highest vs lowest quartile of SHBG, adjusted for BMI and known diabetes risk factors]. The associations remained consistent within ethnic groups [RR, 0.19 (95% CI, 0.10-0.38) for blacks; RR, 0.17 (95% CI, 0.05-0.57) for Hispanics; and 0.13 (95% CI, 0.03-0.48) for Asians]. Adjustment for potential confounders, such as total testosterone (RR, 0.11; 95% CI, 0.07-0.19) or HOMA-IR (RR, 0.26; 95% CI, 0.14-0.48) did not alter the RR substantially. In addition, SHBG concentrations were significantly associated with risk of clinical diabetes across categories of hormone therapy use (never users: RRper SD = 0.42, 95% CI, 0.34-0.51; past users: RRper SD = 0.53;, 95% CI, 0.37-0.77; current users: RRper SD = 0.57; 95% CI, 0.46-0.69; P-interaction = 0.10). CONCLUSIONS: In this prospective study of postmenopausal women, we observed a robust, inverse relationship between serum concentrations of SHBG and risk of clinical diabetes in American blacks, Hispanics, and Asians/Pacific Islanders. These associations appeared to be independent of sex hormone concentrations, adiposity, or insulin resistance.

Original languageEnglish (US)
Pages (from-to)1457-1466
Number of pages10
JournalClinical Chemistry
Volume58
Issue number10
DOIs
StatePublished - Oct 1 2012
Externally publishedYes

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Sex Hormone-Binding Globulin
Medical problems
Hispanic Americans
Prospective Studies
Asian Americans
Adiposity
Gonadal Steroid Hormones
Women's Health
Ethnic Groups
Observational Studies
Insulin Resistance
Testosterone
Hormones

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Sex hormone-binding globulin and risk of clinical diabetes in American black, Hispanic, andAsian/Pacific islander postmenopausal women. / Chen, Brian H.; Brennan, Kathleen; Goto, Atsushi; Song, Yiqing; Aziz, Najib; You, Nai Chieh Y.; Wellons, Melissa F.; Manson, Jo Ann E.; White, Donna L.; Butch, Anthony W.; Liu, Simin.

In: Clinical Chemistry, Vol. 58, No. 10, 01.10.2012, p. 1457-1466.

Research output: Contribution to journalArticle

Chen, BH, Brennan, K, Goto, A, Song, Y, Aziz, N, You, NCY, Wellons, MF, Manson, JAE, White, DL, Butch, AW & Liu, S 2012, 'Sex hormone-binding globulin and risk of clinical diabetes in American black, Hispanic, andAsian/Pacific islander postmenopausal women', Clinical Chemistry, vol. 58, no. 10, pp. 1457-1466. https://doi.org/10.1373/clinchem.2012.193086
Chen, Brian H. ; Brennan, Kathleen ; Goto, Atsushi ; Song, Yiqing ; Aziz, Najib ; You, Nai Chieh Y. ; Wellons, Melissa F. ; Manson, Jo Ann E. ; White, Donna L. ; Butch, Anthony W. ; Liu, Simin. / Sex hormone-binding globulin and risk of clinical diabetes in American black, Hispanic, andAsian/Pacific islander postmenopausal women. In: Clinical Chemistry. 2012 ; Vol. 58, No. 10. pp. 1457-1466.
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abstract = "BACKGROUND: Recent prospective studies have shown a strong inverse association between sex hormone-binding globulin (SHBG) concentrations and risk of clinical diabetes in white individuals. However, it remains unclear whether this relationship extends to other racial/ethnic populations. METHODS: We evaluated the association between baseline concentrations of SHBG and clinical diabetes risk in the Women's Health Initiative Observational Study. Over a median follow-up of 5.9 years, we identified 642 postmenopausal women who developed clinical diabetes (380 blacks, 157 Hispanics, 105 Asians) and 1286 matched controls (777 blacks, 307 Hispanics, 202 Asians). RESULTS: Higher concentrations of SHBG at baseline were associated with a significantly lower risk of clinical diabetes [relative risk (RR), 0.15; 95{\%} CI, 0.09-0.26 for highest vs lowest quartile of SHBG, adjusted for BMI and known diabetes risk factors]. The associations remained consistent within ethnic groups [RR, 0.19 (95{\%} CI, 0.10-0.38) for blacks; RR, 0.17 (95{\%} CI, 0.05-0.57) for Hispanics; and 0.13 (95{\%} CI, 0.03-0.48) for Asians]. Adjustment for potential confounders, such as total testosterone (RR, 0.11; 95{\%} CI, 0.07-0.19) or HOMA-IR (RR, 0.26; 95{\%} CI, 0.14-0.48) did not alter the RR substantially. In addition, SHBG concentrations were significantly associated with risk of clinical diabetes across categories of hormone therapy use (never users: RRper SD = 0.42, 95{\%} CI, 0.34-0.51; past users: RRper SD = 0.53;, 95{\%} CI, 0.37-0.77; current users: RRper SD = 0.57; 95{\%} CI, 0.46-0.69; P-interaction = 0.10). CONCLUSIONS: In this prospective study of postmenopausal women, we observed a robust, inverse relationship between serum concentrations of SHBG and risk of clinical diabetes in American blacks, Hispanics, and Asians/Pacific Islanders. These associations appeared to be independent of sex hormone concentrations, adiposity, or insulin resistance.",
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T1 - Sex hormone-binding globulin and risk of clinical diabetes in American black, Hispanic, andAsian/Pacific islander postmenopausal women

AU - Chen, Brian H.

AU - Brennan, Kathleen

AU - Goto, Atsushi

AU - Song, Yiqing

AU - Aziz, Najib

AU - You, Nai Chieh Y.

AU - Wellons, Melissa F.

AU - Manson, Jo Ann E.

AU - White, Donna L.

AU - Butch, Anthony W.

AU - Liu, Simin

PY - 2012/10/1

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N2 - BACKGROUND: Recent prospective studies have shown a strong inverse association between sex hormone-binding globulin (SHBG) concentrations and risk of clinical diabetes in white individuals. However, it remains unclear whether this relationship extends to other racial/ethnic populations. METHODS: We evaluated the association between baseline concentrations of SHBG and clinical diabetes risk in the Women's Health Initiative Observational Study. Over a median follow-up of 5.9 years, we identified 642 postmenopausal women who developed clinical diabetes (380 blacks, 157 Hispanics, 105 Asians) and 1286 matched controls (777 blacks, 307 Hispanics, 202 Asians). RESULTS: Higher concentrations of SHBG at baseline were associated with a significantly lower risk of clinical diabetes [relative risk (RR), 0.15; 95% CI, 0.09-0.26 for highest vs lowest quartile of SHBG, adjusted for BMI and known diabetes risk factors]. The associations remained consistent within ethnic groups [RR, 0.19 (95% CI, 0.10-0.38) for blacks; RR, 0.17 (95% CI, 0.05-0.57) for Hispanics; and 0.13 (95% CI, 0.03-0.48) for Asians]. Adjustment for potential confounders, such as total testosterone (RR, 0.11; 95% CI, 0.07-0.19) or HOMA-IR (RR, 0.26; 95% CI, 0.14-0.48) did not alter the RR substantially. In addition, SHBG concentrations were significantly associated with risk of clinical diabetes across categories of hormone therapy use (never users: RRper SD = 0.42, 95% CI, 0.34-0.51; past users: RRper SD = 0.53;, 95% CI, 0.37-0.77; current users: RRper SD = 0.57; 95% CI, 0.46-0.69; P-interaction = 0.10). CONCLUSIONS: In this prospective study of postmenopausal women, we observed a robust, inverse relationship between serum concentrations of SHBG and risk of clinical diabetes in American blacks, Hispanics, and Asians/Pacific Islanders. These associations appeared to be independent of sex hormone concentrations, adiposity, or insulin resistance.

AB - BACKGROUND: Recent prospective studies have shown a strong inverse association between sex hormone-binding globulin (SHBG) concentrations and risk of clinical diabetes in white individuals. However, it remains unclear whether this relationship extends to other racial/ethnic populations. METHODS: We evaluated the association between baseline concentrations of SHBG and clinical diabetes risk in the Women's Health Initiative Observational Study. Over a median follow-up of 5.9 years, we identified 642 postmenopausal women who developed clinical diabetes (380 blacks, 157 Hispanics, 105 Asians) and 1286 matched controls (777 blacks, 307 Hispanics, 202 Asians). RESULTS: Higher concentrations of SHBG at baseline were associated with a significantly lower risk of clinical diabetes [relative risk (RR), 0.15; 95% CI, 0.09-0.26 for highest vs lowest quartile of SHBG, adjusted for BMI and known diabetes risk factors]. The associations remained consistent within ethnic groups [RR, 0.19 (95% CI, 0.10-0.38) for blacks; RR, 0.17 (95% CI, 0.05-0.57) for Hispanics; and 0.13 (95% CI, 0.03-0.48) for Asians]. Adjustment for potential confounders, such as total testosterone (RR, 0.11; 95% CI, 0.07-0.19) or HOMA-IR (RR, 0.26; 95% CI, 0.14-0.48) did not alter the RR substantially. In addition, SHBG concentrations were significantly associated with risk of clinical diabetes across categories of hormone therapy use (never users: RRper SD = 0.42, 95% CI, 0.34-0.51; past users: RRper SD = 0.53;, 95% CI, 0.37-0.77; current users: RRper SD = 0.57; 95% CI, 0.46-0.69; P-interaction = 0.10). CONCLUSIONS: In this prospective study of postmenopausal women, we observed a robust, inverse relationship between serum concentrations of SHBG and risk of clinical diabetes in American blacks, Hispanics, and Asians/Pacific Islanders. These associations appeared to be independent of sex hormone concentrations, adiposity, or insulin resistance.

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