Changes in Visceral Adiposity, Subcutaneous Adiposity, and Sex Hormones in the Diabetes Prevention Program.

Catherine Kim, Dana Dabelea, Rita R Kalyani, Costas A Christophi, George A Bray, Xavier Pi-Sunyer, Christine H Darwin, Swaytha Yalamanchi, Elizabeth Barrett-Connor, Sherita Hill Golden, Edward J Boyko

Journal: The Journal of clinical endocrinology and metabolism 2017;102(9):3381-3389

PMID: 28651370

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Plain Language Summary

It is not currently known to what extent changes in different types of fat stores (visceral fat that surrounds organs and subcutaneous fat that sits under the surface of the skin) relate to changes in sex hormones. This study was a secondary analysis of a randomised controlled trial including 555 individuals. It examined whether changes to visceral and subcutaneous fat were associated with changes in sex hormones (DHEA, testosterone, oestrogen and sex hormone binding globulin - SHBG) among overweight individuals with glucose intolerance under the care of a diabetes program. Participants were randomly assigned to an intensive lifestyle modification programme (goals for weight reduction and 150 mins exercise weekly), medication (metformin) or placebo for 12 months. The authors found that among men, reductions in both types of fat were associated with significant increases in total testosterone and SHBG. Among women, reductions in both types of fat were associated with increases in SHBG and associations with estrone differed by menopausal status. No associations were found between changes in fat stores and estradiol or DHEA. The authors conclude that weight loss may affect sex hormone profiles via reductions in visceral and subcutaneous fat. -

Abstract

CONTEXT

The degree to which changes in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) relate to corresponding changes in plasma sex steroids is not known.

OBJECTIVE

We examined whether changes in VAT and SAT areas assessed by computed tomography were associated with changes in sex hormones [dehydroepiandrosterone sulfate (DHEAS), testosterone, estradiol, estrone, and sex hormone binding globulin (SHBG)] among Diabetes Prevention Program participants.

DESIGN

Secondary analysis of a randomized trial.

PARTICIPANTS

Overweight and glucose-intolerant men (n = 246) and women (n = 309).

INTERVENTIONS

Intensive lifestyle change with goals of weight reduction and 150 min/wk of moderate intensity exercise or metformin administered 850 mg twice a day or placebo.

MAIN OUTCOME MEASURES

Associations between changes in VAT, SAT, and sex hormone changes over 1 year.

RESULTS

Among men, reductions in VAT and SAT were both independently associated with significant increases in total testosterone and SHBG in fully adjusted models. Among women, reductions in VAT and SAT were both independently associated with increases in SHBG and associations with estrone differed by menopausal status. Associations were similar by race/ethnicity and by randomization arm. No significant associations were observed between change in fat depot with change in estradiol or DHEAS.

CONCLUSIONS

Among overweight adults with impaired glucose intolerance, reductions in either VAT and SAT were associated with increased total testosterone in men and higher SHBG in men and women. Weight loss may affect sex hormone profiles via reductions in visceral and subcutaneous fat.

Address: Departments of Medicine, Obstetrics & Gynecology, and Epidemiology, University of Michigan, Ann Arbor, Michigan 48109.; Department of Epidemiology, University of Colorado, Denver, Colorado 80045.; Department of Medicine, Johns Hopkins University, Baltimore, Maryland 21287.; Biostatistics Center, George Washington University, Rockville, Maryland 20852.; Pennington Biomedical Research Center, Louisiana State University Medical Center, Baton Rouge, Louisiana 70808.; Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10025.; Department of Medicine, University of California, Los Angeles, California 90095.; Department of Family and Preventive Medicine, University of California, San Diego, California 92093.; Department of Medicine, University of Washington, Veterans Affairs Puget Sound Health Care System, Seattle, Washington 98108.

DOI: 10.1210/jc.2017-00967

Patient Centred Factor

Triggers: visceral and subcutaneous adiposity

Clinical Imbalances

Hormonal Structural Integrity and Musculoskeletal

Laboratory Testing

Blood Imaging

Modifiable Lifestyle Factors

Diet Exercise and movement

Allocation Concealment

Yes

Nutrition Evidence Keywords

Visceral fat

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Other Literature Sources:

https://scite.ai/reports/28651370

Miscellaneous:

https://assays.cancer.gov/non-CPTAC-4061

Research Materials:

https://antibodies.cancer.gov/detail/CPTC-SAT1-1

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MeSH Terms: Adult, Blood Glucose, Diabetes Mellitus, Estradiol, Female, Glucose Intolerance, Gonadal Steroid Hormones, Humans, Intra-Abdominal Fat, Life Style, Linear Models, Male, Metformin, Middle Aged, Obesity, Primary Prevention, Program Evaluation, Risk Assessment, Statistics, Nonparametric, Subcutaneous Fat, Testosterone