Publication Description
Context: It is unclear whether relative elevations in androgens or irregular menses (IM) are associated with greater cardiometabolic risk among women who are already overweight and glucose intolerant. Research Design and Methods: We conducted a secondary analysis of Diabetes Prevention Program (DPP) and the DPP Outcomes Study (DPPOS). Participants included women with sex hormone measurements who did not use exogenous estrogen (n=1422). We examined whether free androgen index (FAI) or IM were associated with diabetes risk during the DPP/DPPOS or with coronary artery calcification (CAC) at DPPOS year 10. Models were adjusted for menopausal status, age, race/ethnicity, randomization arm, body mass index (BMI), and hemoglobin A1c. Results: Women had an average age of 48.2+/-9.9 years. Elevations in FAI and IM were associated with greater BMI, waist circumference, blood pressure, and lower adiponectin. FAI was not associated with diabetes risk during the DPP/DPPOS (HR 0.97, 95% CI 0.93, 1.02) or increased odds of CAC (OR 1.06, 95% CI 0.92, 1.23). IM was also not associated with diabetes risk during the DPP/DPPOS (HR 1.07, 95% CI 0.87, 1.31) or increased odds of CAC (OR 0.89, 95 % CI 0.53, 1.49). Women who had both relative elevations in FAI as well as IM had similar diabetes risk and odds of CAC as women without these conditions. Differences by treatment arm and menopausal status were not observed. Conclusions: Among midlife women who were already glucose-intolerant and overweight, androgen concentrations and irregular menses did not additionally contribute to increased risk for diabetes or CAC.