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Changes over 14 Years in Androgenicity and Body Mass Index in a Biracial Cohort of Reproductive-Age Women

Division of Research (B.S., C.P.Q., H.W., S.-F.J., S.S.), Kaiser Permanente, Oakland, California 94612; Northwestern Medical School (K.L., M.D.), Chicago, Illinois 60611; Brown Foundation Institute of Molecular Medicine (M.F.), The University of Texas Health Science Center, Houston, Texas 77030; Division of Preventive Medicine (C.E.L., O.D.W.), Department of Medicine, and Obstetrics/Gynecology Research and Diagnostic Laboratory (J.M.), University of Alabama at Birmingham, Birmingham, Alabama 35294; Division of Epidemiology and Community Health (P.J.S.), University of Minnesota, Minneapolis, Minnesota 55455; and Departments of Epidemiology (S.M.S., D.S.S.) and Medicine (D.S.S.), University of Washington, Seattle, Washington 98101

Address all correspondence and requests for reprints to: Barbara Sternfeld, Ph.D., Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, California 94612. E-mail: bxs{at}dor.kaiser.org.

Background: Body mass index (BMI) is directly related to testosterone (total T and free T) and inversely to SHBG cross-sectionally, but little is known about how changes in body fat and androgen markers affect each other over time.

Methods: Participants included 969 White and Black women from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort, who were ages 18–30 at entry into the study and were pre- or perimenopausal 16 yr later at the time of the CARDIA Women’s Study (CWS). Total T and SHBG were assayed from specimens drawn at the CWS examination and stored serum from the yr 2 and 10 CARDIA exams. Free T was calculated based on total T and SHBG. BMI and waist circumference were measured at yr 2, 10, and 16.

Results: Despite clinically significant increases in BMI and waist circumference, total T and free T tended to decline, whereas SHBG remained relatively constant. BMI and waist circumference were directly correlated with free T and inversely correlated with SHBG in cross-sectional analyses. In longitudinal, multivariable analyses, an annualized increase in BMI was inversely related to a concurrent annualized decrease in SHBG (β = –0.79 ng/dl, and SE = 0.22 in Blacks; β = –1.07 ng/dl; and SE = 0.31 in Whites). However, early increases in BMI were not related to later decreases in SHBG.

Conclusion: Increases in adiposity are closely tied to decreases in SHBG, but changes in BMI and SHBG may occur concurrently rather than sequentially.