Abstract 4186: The Association of Central Obesity With Sex Hormones Differs Between Men and Women in the MultiEthnic Study of Atherosclerosis (MESA)
Sex hormones affect adipose tissue metabolism and adipose tissue also metabolizes sex hormones for local effects. Central obesity is associated with a pro-atherogenic metabolic state. We analyzed cross sectional associations of endogenous sex hormones (SH: bioavailable Testosterone, BioT; estradiol, E2; dehydroepiandrostenedione, DHEA; SH binding globulin, SHBG) with waist circumference (WC) or waist to hip ratio (WHR) in men and women.
Methods: Analysis included 3163 men and 2051 postmenopausal women who were not on hormone therapy, (45– 84 years, 36% white, 13% Chinese, 28% African-American, 23% Hispanic) at MESA baseline examination. Analyses of interaction by sex were performed on the whole as well as race-stratified dataset. Estimations of association measures were done on sex-stratified race-pooled models. Unadjusted associations were assessed by Spearman rank correlations. WC (or WHR) was regressed on log-transformed SH adjusted for age, race, systolic BP, smoking and fasting glucose.
Results: The WC was 99.2±12.2cm in men and 98.6±15.6cm in women (p= 0.100). WHR was higher in men (96±7%) than women (92±8%, p<0.001). We found an unadjusted negative association of WC with BioT in men, but in women the association was positive (Table⇓, Spearman rho). DHEA was negatively associated with WC in men. In both men and women, E2 was positively associated and SHBG was negatively associated with WC. In adjusted models (Table⇓, coefficients), the findings for BioT, E2 and SHBG remained, while DHEA was associated with lower WC in both men and women. Sex differences were similar in race-stratified models. The interactions by sex were qualitatively similar for WHR in pooled and race stratified models.
Conclusions: In men and women, E2 is associated with greater central obesity, while DHEA and SHBG are associated with lower central obesity. This suggests that the hypoandrogenic state may be metabolically favorable in women, but unfavorable in men.