The mediatory role of androgens on sex differences in glucose homeostasis and incidence of type 2 diabetes: the KORA study
Authors' conclusion
The dimorphic mediatory role of TT highlights its complex role in metabolic health, contributing differently to the glucose dysregulation and risk of T2D in men and women.
Study context
- Population
- German population-based KORA F4 study (mean age 54 years, 41% women) and follow-up KORA FF41,412 at follow-up
- Participants
- 1,975 participants
- Exposure
- Women vs men; mediation by androgens
- Outcome
- Mediating role of androgens (TT, DHEA, DHEAs) in the association of sex with glucose- and insulin-related traits and incidence of T2D
- Follow-up
- Median 6.5 years
Methodological detailscross-sectional and longitudinal analyses, mediation analysis, T2D self-reported, confirmed by physicians and/or medical charts
- Cross-sectional and longitudinal analyses
- Mediation analysis
- T2D self-reported, confirmed by physicians and/or medical charts
Main finding
As reported in the abstract
Mediating role of TT in the association of sex (women vs men) with glucose- and insulin-related traits and incident T2D
- Indirect effects (IE) of total testosterone (TT) on sex–fasting glucose association: β
- 3.08 (2.04, 4.30) (95% CI)
- IE of TT on sex–fasting insulin association: β
- 0.39 (0.30, 0.47) (95% CI)
- IE of TT on sex–2 h-glucose association: β
- 12.77 (9.01, 16.03) (95% CI)
- IE of TT on sex–HOMA-IR association: β
- 0.41 (0.33, 0.50) (95% CI)
- Inconsistent mediation by TT of sex–incident T2D association: Direct effects (DE)
- 0.12 (0.06, 0.20) (95% CI)
- Inconsistent mediation by TT of sex–incident T2D association: IE OR
- 7.60 (3.43, 24.54) (95% CI)
Observational data: associations, not effects.
Further findings
Sex differences in androgens and glucose/insulin traits
- Women had lower TT, dehydroepiandrosterone-sulfate (DHEAs), fasting glucose, fasting insulin, 2 h-glucose and HOMA-IR vs men (adjusted)
- TT inversely associated with glucose- and insulin-related traits in men; positively with fasting glucose in women
Original publication
The mediatory role of androgens on sex differences in glucose homeostasis and incidence of type 2 diabetes: the KORA study. Cardiovasc Diabetol. Published 15 November 2024. doi:10.
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