Effects of Sex and Hormone Replacement Therapy Use on the Prevalence of Isolated Impaired Fasting Glucose and Isolated Impaired Glucose Tolerance in Subjects With a Family History of Type 2 Diabetes
- Renate E. van Genugten1,
- Kristina M. Utzschneider1,
- Jenny Tong1,
- Fernando Gerchman1,
- Sakeneh Zraika1,
- Jayalakshmi Udayasankar1,
- Edward J. Boyko23,
- Wilfred Y. Fujimoto1,
- Steven E. Kahn1 and
- and the American Diabetes Association GENNID Study Group
- 1Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, Washington
- 2Department of Medicine, Division of General Internal Medicine, VA Puget Sound Health Care System and University of Washington, Seattle, Washington
- 3Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington
- Address correspondence and reprint requests to Kristina Utzschneider, MD, VA Puget Sound Health Care System (151), 1660 S. Columbian Way, Seattle, WA 98108. E-mail: kutzschn{at}u.washington.edu
Abstract
Impaired fasting glucose (IFG) is more prevalent in men and impaired glucose tolerance (IGT) more prevalent in women. To explore whether this sex difference is related to female sex hormones, we performed a cross-sectional analysis of data from 2,164 (1,329 women and 835 men) first-degree relatives of individuals with type 2 diabetes. Subjects were categorized based on a 75-g oral glucose tolerance test. Sex and hormone replacement therapy (HRT) effects on the distribution of glucose tolerance were assessed using multinomial logistic regression corrected for familial clustering. Compared with men, women were more likely to have isolated IGT (relative risk 1.8 [95% CI 1.3–2.5]) and less likely to have isolated IFG (0.5 [0.3–0.7]) adjusted for ethnicity, age, waist, fasting insulin, and early insulin release (ΔI0–30/ΔG0–30). To evaluate HRT effects, postmenopausal women using (n = 238) or not using (n = 378) HRT were compared. HRT users were more likely to have isolated IGT (2.2 [1.2–4.0]) after adjustment, but the prevalence of isolated IFG did not differ by HRT status. Based on the influence of sex and HRT on the prevalence of isolated IFG and isolated IGT, we conclude that female sex hormones may play an important role in the pathogenesis of IFG and IGT.
- FPG, fasting plasma glucose
- GENNID, Genetics of Type 2 Diabetes
- IFG, impaired fasting glucose
- IGT, impaired glucose tolerance
- HRT, hormone replacement therapy
- NGT, normal glucose tolerance
- OGTT, oral glucose tolerance test
Footnotes
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R.E.v.G. and K.M.U. contributed equally to this work.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Accepted August 23, 2006.
- Received April 28, 2006.
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