1. SHBG, Free Testosterone, and Type 2 Diabetes Risk in Middle-aged African Men: A Longitudinal Study.
- Author
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Seipone, Ikanyeng D, Mendham, Amy E, Storbeck, Karl-Heinz, Oestlund, Imken, Kufe, Clement N, Chikowore, Tinashe, Masemola, Maphoko, Crowther, Nigel J, Kengne, Andre Pascal, Norris, Shane, Olsson, Tommy, Brown, Todd, Micklesfield, Lisa K, and Goedecke, Julia H
- Subjects
BLACK South Africans ,INSULIN sensitivity ,TYPE 2 diabetes ,MIDDLE-aged men ,GLUCOSE metabolism - Abstract
Objectives To investigate longitudinal changes in SHBG and free testosterone (free T) levels among Black middle-aged African men, with and without coexistent HIV, and explore associations with incident dysglycaemia and measures of glucose metabolism. Design This longitudinal study enrolled 407 Black South African middle-aged men, comprising primarily 322 men living without HIV (MLWOH) and 85 men living with HIV (MLWH), with normal fasting glucose at enrollment. Follow-up assessments were conducted after 3.1 ± 1.5 years. Methods At baseline and follow-up, SHBG, albumin, and total testosterone were measured and free T was calculated. An oral glucose tolerance test at follow-up determined dysglycaemia (impaired fasting glucose, impaired glucose tolerance, type 2 diabetes) and glucose metabolism parameters including insulin sensitivity (Matsuda index), insulin resistance (homeostasis model assessment of insulin resistance), and beta(β)-cell function (disposition index). The primary analysis focussed on MLWOH, with a subanalysis on MLWH to explore whether associations in MLWOH differed from MLWH. Results The prevalence of dysglycaemia at follow-up was 17% (n = 55) in MLWOH. Higher baseline SHBG was associated with a lower risk of incident dysglycaemia (odds ratio 0.966; 95% confidence interval 0.945-0.987) and positively associated with insulin sensitivity (β = 0.124, P <.001) and β-cell function (β = 0.194, P =.001) at follow-up. Free T did not predict dysglycaemia. In MLWH, dysglycaemia prevalence at follow-up was 12% (n = 10). Neither baseline SHBG nor free T were associated with incident dysglycaemia and glucose metabolism parameters in MLWH. Conclusion SHBG levels predict the development of dysglycaemia in middle-aged African men but do not exhibit the same predictive value in MLWH. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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