Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Epidemiology and Population Health

Association of baseline sex hormone levels with baseline and longitudinal changes in waist-to-hip ratio: Multi-Ethnic Study of Atherosclerosis

International Journal of Obesity volume 36, pages 1578–1584 (2012)Cite this article

Subjects

Abstract

OBJECTIVE:

Waist-to-hip ratio (WHR) is strongly associated with prevalent atherosclerosis. We analyzed the associations of baseline serum levels of testosterone (T), estradiol (E2), sex-hormone-binding globulin (SHBG) and dehydroepiandrosterone (DHEA) with WHR in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort.

SUBJECTS:

Baseline data was available for 3144 men and 2038 postmenopausal women, who were non-users of hormone therapy, who were 45–84 years of age, and of White, Chinese, Black or Hispanic racial/ethnic groups. Of these, 2708 men and 1678 women also had longitudinal measurements of WHR measured at the second and/or the third study visits (median follow-up 578 days and 1135 days, respectively).

RESULTS:

In cross-sectional analyses adjusted for age, race and cardiovascular disease risk factors, T was negatively associated with baseline WHR in men, whereas in both sexes, E2 was positively associated and SHBG was negatively associated with WHR (all P<0.001). In longitudinal analyses, further adjusted for follow-up time and baseline WHR, baseline T was negatively associated with WHR at follow-up (P=0.001) in men, whereas in both sexes, E2 was positively associated (P=0.004) and SHBG was negatively associated with WHR (P<0.001). The longitudinal association of E2, but not T, was independent of SHBG. In cross-sectional or longitudinal analyses, there were no associations between DHEA and WHR in either men or women.

CONCLUSION:

Sex hormones are associated with WHR at baseline and also during follow-up above and beyond their baseline association. Future research is needed to determine if manipulation of hormones is associated with changes in central obesity.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Dixon JB, Dixon ME, O’Brien PE . Depression in association with severe obesity: changes with weight loss. Arch Intern Med 2003; 163: 2058–2065.

    Article  Google Scholar 

  2. Pi-Sunyer FX . Comorbidities of overweight and obesity: current evidence and research issues. Med Sci Sports Exerc 1999; 31 (Suppl 11): S602–S608.

    Article  CAS  Google Scholar 

  3. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath Jr CW . Body-mass index and mortality in a prospective cohort of US adults. N Engl J Med 1999; 341: 1097–1105.

    Article  CAS  Google Scholar 

  4. Manson JE, Willett WC, Stampfer MJ, Colditz GA, Hunter DJ, Hankinson SE et al. Body weight and mortality among women. N Engl J Med 1995; 333: 677–685.

    Article  CAS  Google Scholar 

  5. Smith Jr SC, Blair SN, Bonow RO, Brass LM, Cerqueira MD, Dracup K et al. AHA/ACC guidelines for preventing heart attack and death in patients with atherosclerotic cardiovascular disease: 2001 update. A statement for healthcare professionals from the American Heart Association and the American College of Cardiology. J Am Coll Cardiol 2001; 38: 1581–1583.

    Article  Google Scholar 

  6. Peeters A, Magliano DJ, Stevens J, Duncan BB, Klein R, Wong TY . Changes in abdominal obesity and age-related macular degeneration: the Atherosclerosis Risk in Communities Study. Arch Ophthalmol 2008; 126: 1554–1560.

    Article  Google Scholar 

  7. Maggio M, Lauretani F, Ceda GP, Bandinelli S, Basaria S, Ble A et al. Association between hormones and metabolic syndrome in older Italian men. J Am Geriatr Soc 2006; 54: 1832–1838.

    Article  Google Scholar 

  8. Rohrmann S, Shiels MS, Lopez DS, Rifai N, Nelson WG, Kanarek N et al. Body fatness and sex steroid hormone concentrations in US men: results from III NHANES. Cancer Causes Control 2011; 22: 1141–1151.

    Article  Google Scholar 

  9. Cappola AR, Ratcliffe SJ, Bhasin S, Blackman MR, Cauley J, Robbins J et al. Determinants of serum total and free testosterone levels in women over the age of 65 years. J Clin Endocrinol Metab 2007; 92: 509–516.

    Article  CAS  Google Scholar 

  10. Mahabir S, Baer DJ, Johnson LL, Hartman TJ, Dorgan JF, Campbell WS et al. Usefulness of body mass index as a sufficient adiposity measurement for sex hormone concentration associations in postmenopausal women. Cancer Epidemiol Biomarkers Prev 2006; 15: 2502–2507.

    Article  CAS  Google Scholar 

  11. Mohr BA, Bhasin S, Link CL, O’Donnell AB, McKinlay JB . The effect of changes in adiposity on testosterone levels in older men: longitudinal results from the Massachusetts Male Aging Study. Eur J Endocrinol 2006; 155: 443–452.

    Article  CAS  Google Scholar 

  12. Derby CA, Zilber S, Brambilla D, Morales KH, McKinlay JB . Body mass index, waist circumference and waist to hip ratio and change in sex steroid hormones: the Massachusetts Male Ageing Study. Clin Endocrinol (Oxf) 2006; 65: 125–131.

    Article  CAS  Google Scholar 

  13. Gapstur SM, Kopp P, Gann PH, Chiu BC, Colangelo LA, Liu K . Changes in BMI modulate age-associated changes in sex hormone binding globulin and total testosterone, but not bioavailable testosterone in young adult men: the CARDIA Male Hormone Study. Int J Obes (Lond) 2007; 31: 685–691.

    Article  CAS  Google Scholar 

  14. Freeman EW, Sammel MD, Lin H, Gracia CR . Obesity and reproductive hormone levels in the transition to menopause. Menopause 2010; 17: 718–726.

    Article  Google Scholar 

  15. Janssen I, Powell LH, Crawford S, Lasley B, Sutton-Tyrrell K . Menopause and the metabolic syndrome: the Study of Women's Health Across the Nation. Arch Intern Med 2008; 168: 1568–1575.

    Article  CAS  Google Scholar 

  16. Sutton-Tyrrell K, Zhao X, Santoro N, Lasley B, Sowers M, Johnston J et al. Reproductive hormones and obesity: 9 years of observation from the Study of Women's Health Across the Nation. Am J Epidemiol 2010; 171: 1203–1213.

    Article  Google Scholar 

  17. Sternfeld B, Liu K, Quesenberry Jr CP, Wang H, Jiang SF, Daviglus M et al. Changes over 14 years in androgenicity and body mass index in a biracial cohort of reproductive-age women. J Clin Endocrinol Metab 2008; 93: 2158–2165.

    Article  CAS  Google Scholar 

  18. Bild DE, Bluemke DA, Burke GL, Detrano R, Diez Roux AV, Folsom AR et al. Multi-ethnic study of atherosclerosis: objectives and design. Am J Epidemiol 2002; 156: 871–881.

    Article  Google Scholar 

  19. See R, Abdullah SM, McGuire DK, Khera A, Patel MJ, Lindsey JB et al. The association of differing measures of overweight and obesity with prevalent atherosclerosis: the Dallas Heart Study. J Am Coll Cardiol 2007; 50: 752–759.

    Article  Google Scholar 

  20. Friedewald WT, Levy RI, Fredrickson DS . Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499–502.

    CAS  Google Scholar 

  21. Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 2000; 85: 2402–2410.

    Article  CAS  Google Scholar 

  22. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412–419.

    Article  CAS  Google Scholar 

  23. Vermeulen A, Verdonck L, Kaufman JM . A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 1999; 84: 3666–3672.

    Article  CAS  Google Scholar 

  24. Vazquez G, Duval S, Jacobs Jr DR, Silventoinen K . Comparison of body mass index, waist circumference, and waist/hip ratio in predicting incident diabetes: a meta-analysis. Epidemiol Rev 2007; 29: 115–128.

    Article  Google Scholar 

  25. Olson MB, Shaw LJ, Kaizar EE, Kelsey SF, Bittner V, Reis SE et al. Obesity distribution and reproductive hormone levels in women: a report from the NHLBI-sponsored WISE Study. J Womens Health (Larchmt) 2006; 15: 836–842.

    Article  Google Scholar 

  26. Goodman-Gruen D, Barrett-Connor E . Sex differences in the association of endogenous sex hormone levels and glucose tolerance status in older men and women. Diabetes Care 2000; 23: 912–918.

    Article  CAS  Google Scholar 

  27. Khaw KT, Barrett-Connor E . Lower endogenous androgens predict central adiposity in men. Ann Epidemiol 1992; 2: 675–682.

    Article  CAS  Google Scholar 

  28. Goodman-Gruen D, Barrett-Connor E . Total but not bioavailable testosterone is a predictor of central adiposity in postmenopausal women. Int J Obes Relat Metab Disord 1995; 19: 293–298.

    CAS  PubMed  Google Scholar 

  29. Kupelian V, Page ST, Araujo AB, Travison TG, Bremner WJ, McKinlay JB . Low sex hormone-binding globulin, total testosterone, and symptomatic androgen deficiency are associated with development of the metabolic syndrome in nonobese men. J Clin Endocrinol Metab 2006; 91: 843–850.

    Article  CAS  Google Scholar 

  30. Kaukua J, Pekkarinen T, Sane T, Mustajoki P . Sex hormones and sexual function in obese men losing weight. Obes Res 2003; 11: 689–694.

    Article  CAS  Google Scholar 

  31. Wabitsch M, Hauner H, Heinze E, Bockmann A, Benz R, Mayer H et al. Body fat distribution and steroid hormone concentrations in obese adolescent girls before and after weight reduction. J Clin Endocrinol Metab 1995; 80: 3469–3475.

    CAS  Google Scholar 

  32. Pasquali R, Antenucci D, Casimirri F, Venturoli S, Paradisi R, Fabbri R et al. Clinical and hormonal characteristics of obese amenorrheic hyperandrogenic women before and after weight loss. J Clin Endocrinol Metab 1989; 68: 173–179.

    Article  CAS  Google Scholar 

  33. Kahn SM, Hryb DJ, Nakhla AM, Romas NA, Rosner W . Sex hormone-binding globulin is synthesized in target cells. J Endocrinol 2002; 175: 113–120.

    Article  CAS  Google Scholar 

  34. Pascal N, Amouzou EK, Sanni A, Namour F, Abdelmouttaleb I, Vidailhet M et al. Serum concentrations of sex hormone binding globulin are elevated in kwashiorkor and anorexia nervosa but not in marasmus. Am J Clin Nutr 2002; 76: 239–244.

    Article  CAS  Google Scholar 

  35. Plymate SR, Jones RE, Matej LA, Friedl KE . Regulation of sex hormone binding globulin (SHBG) production in Hep G2 cells by insulin. Steroids 1988; 52: 339–340.

    Article  CAS  Google Scholar 

  36. Pugeat M, Crave JC, Elmidani M, Nicolas MH, Garoscio-Cholet M, Lejeune H et al. Pathophysiology of sex hormone binding globulin (SHBG): relation to insulin. J Steroid Biochem Mol Biol 1991; 40: 841–849.

    Article  CAS  Google Scholar 

  37. Fernandez-Real JM, Grasa M, Casamitjana R, Pugeat M, Barret C, Ricart W . Plasma total and glycosylated corticosteroid-binding globulin levels are associated with insulin secretion. J Clin Endocrinol Metab 1999; 84: 3192–3196.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank the other investigators, the staff and the participants of the MESA study for their valuable contributions. This research was supported by RO1 HL074406, RO1 HL-74338, UL1 RR 025005 and contracts N01-HC-95159 through N01-HC-95165 and N01-HC-95169 from the National Heart, Lung and Blood Institute. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org. DV was supported by the National Center for Research Resources (Grant No. UL1 RR 025005), a component of the National Institutes of Health.

Author information

Authors and Affiliations

  1. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    D Vaidya, A Dobs, S H Golden & P Ouyang

  2. American Cancer Society, Northwest Atlanta, GA, USA

    S M Gapstur

  3. University of Vermont, Burlington, VT, USA

    M Cushman

  4. Northwestern University, Chicago, IL, USA

    K Liu

Authors
  1. D Vaidya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A Dobs
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S M Gapstur
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S H Golden
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M Cushman
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P Ouyang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D Vaidya.

Ethics declarations

Competing interests

The Multi-Ethnic Study of Atherosclerosis Publications and Presentations Committee reviews publications independently of the NIH. DV received compenstation as consultant for Excet Inc. All other authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vaidya, D., Dobs, A., Gapstur, S. et al. Association of baseline sex hormone levels with baseline and longitudinal changes in waist-to-hip ratio: Multi-Ethnic Study of Atherosclerosis. Int J Obes 36, 1578–1584 (2012). https://doi.org/10.1038/ijo.2012.3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2012.3

Keywords

This article is cited by

Search

Advanced search

Quick links