Association of Hyperandrogenemia and H y p e re s t rogenemia With Type 2 Diabetes in Hispanic Postmenopausal

C onsiderable evidence suggests a re l a-tionship between androgenicity and c o ro n a ry heart disease (CHD) in women. An increase in waist-to-hip ratio (WHR), which appears to be an andro g e n i c p a t t e rn of obesity in women (1–6), has been re p o rted to be associated in women with CHD (1,7,8) and coro n a ry art e ry disease (CAD) (9–12). Hirsutism (10) and polycystic ovary syndrome (PCOS) (13), which are androgenic states, have also been found to be associated with CAD. A positive relationship between free testostero n e (FT) level and the degree of CAD in women has recently been re p o rted (14). Support for an androgen–CAD relationship and evidence that it may be a cause-and-effect re l at i o nship has been re p o rted in female m o nkeys in which testosterone administration was found to exacerbate diet-induced a t h e ro s c l e rosis independently of any eff e c t s on risk factors for CHD (15). A possible mechanism for an andro-gen–CHD relationship is that andro g e n i city in women may underlie the expre s s i o n of risk factors for CHD; this possibility is suggested by the positive relationship of a n d rogens to risk factors for CHD in women (14,16). An increase in the levels of testosterone or FT with the risk factors h y p e rtension (17,18), smoking (19), and i n c reased WHR (3–6) and a positive correlation of testosterone or FT with blood p re s s u re level 21) have been re p o rted in women. Fur-t h e rm o re, the androgenic states PCOS have both been re p o rted to be associated with risk factors for CHD, and a n d rogen administration to women has been re p o rted to selectively increase vis-ceral adipose (27), which in turn may cause the expression of risk factors for CHD (28) and/or serve as a marker for them (14). Because type 2 diabetes is one of the strongest risk factors for CHD in women (29), the present study was carried out to determine whether hyperan-d rogenemia is also associated with type 2 F rom the Departments of Medicine (A table elsewhere in this …

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