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

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


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
Issue number10
StatePublished - Oct 2012

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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