Sex Hormone-binding Globulin (SHBG), Testosterone, and Type 2 Diabetes Risk in Middle-Aged African Women: Exploring the Effect of HIV and Menopause
Authors' conclusion
We show for the first time that midlife African WH have higher SHBG and lower total and free testosterone than WOH, which corresponded to their higher β-cell function, suggesting a putative protective effect of SHBG on T2D risk in WH.
Study context
- Population
- Middle-aged Black African women from the Middle-Aged Soweto Cohort (MASC), Health Research Unit in Soweto, Johannesburg, South Africa81 premenopausal, 280 postmenopausal
- Participants
- 57 / 24 / 236 / 44
- Exposure
- Women living with HIV vs without HIV, by menopausal status
- Premenopausal without HIV (WOH)n = 57reference
- Premenopausal with HIV (WH)n = 24
- Postmenopausal WOHn = 236reference
- Postmenopausal WHn = 44
- Outcome
- Circulating SHBG and sex hormones, body composition (DXA), insulin sensitivity (Matsuda index), secretion (insulinogenic index) and clearance, β-cell function (disposition index)
Methodological detailsobservational
- Observational
Main finding
As reported in the abstract
SHBG and testosterone by HIV status
- SHBG higher and total and free testosterone lower in postmenopausal WH than WOH
- Postmenopausal WH vs Postmenopausal WOH: all P ≤ .023
Observational data: associations, not effects.
Further findings
SHBG and insulin/β-cell measures
- SHBG–Matsuda index association stronger in premenopausal than postmenopausal women
- P = 0.043 for interaction
- Irrespective of HIV status, SHBG positively associated with Matsuda index, insulin clearance and DI and inversely with HOMA-IR (all P < .011)
Free testosterone and insulin measures
- Free testosterone (not total) negatively associated with basal insulin clearance
- P = 0.021
- Free testosterone positively associated with HOMA-IR in premenopausal, not postmenopausal women
- P = 0.015 for interaction
Original publication
SHBG, Testosterone, and Type 2 Diabetes Risk in Middle-Aged African Women: Exploring the Effect of HIV and Menopause. J Clin Endocrinol Metab. Published 28 April 2025. doi:10.
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