Objective: To investigate the relationship between testosterone level and related index and metabolic syndrome (MS) of women in perimenopause or postmenopause period.
Methods: From May 2009 to August 2010, 911 women aged 40-65 years underwent physical examination in the Memorial Hospital, Sun Yat-sen University were enrolled in this study, which were divided into 175 women with early perimenopause period in group A, 112 women late perimenopause period in group B, 161 women with early postmenopause period in group C, 132 women with moderate postmenopause period in group D, 88 women with late postmenopause period in group E, 243 women with regular menstruation as control group (group F). MS was defined according to the International Diabetes Federation (IDF) criteria. The relationship of free testosterone level and MS of women in different stage of menopause was analyzed.
Results: (1) Compared with 1.13 nmol/L in group F, median testosterone level of 1.03 nmol/L in group A, 0.91 nmol/L in group B, 0.91 nmol/L in group C, 0.87 nmol/L in group D, 0.83 nmol/L in group E decreased significantly at early peri-menopause period (P < 0.01). Median free androgen index (FAI) was 1.33 in group A, 1.56 in group B, 1.69 in group F. When compared median FAI in group A with those in group F or B, it all showed significantly difference (P < 0.01); Testosterone (T)/estradiol (E(2)) were 0.042 in group C, 0.040 in group D, 0.042 in group E, 0.010 in group A. When compared T/E(2) in group C with group F, D and E, it all reached statistical difference (P < 0.01). (2) There were negative correlation among waist circumference (WC, r = -0.287), fasting blood glucose (FBG, r = -0.281), triglyceride (TG, r = -0.224) and sex hormone-binding globulin (SHBG) and positive correlation with high density lipoprotein cholesterone (HDL-C, r = 0.314). The logistic regression analysis for MS showed that the MS was associated with SHBG significantly (OR = 0.993, 95%CI: 0.986 - 0.999, P = 0.035). (3) When cut-off value of SHBG was defined at 56.14 nmol/L, SHBG was used to predict MS with sensitivity of 63.13% and specificity of 69.45%.
Conclusions: Serum testosterone was associated with MS in women at perimenopausal and postmenopausal period, so window period of preventing MS was set at perimenopausal period. A serum testosterone level was elevated from premenopause to postmenopause period. Because there was an association between SHBG and MS, SHBG was a selectable parameter to predict MS.