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The association between serum testosterone and insulin resistance: a longitudinal study

Journal article
Authors Kristin Ottarsdottir
Anna G Nilsson
Margareta Hellgren
Ulf Lindblad
Bledar Daka
Published in Endocrine Connections
Volume 7
Issue 12
Pages 1491-1500
ISSN 2049-3614
Publication year 2018
Published at Institute of Medicine, School of Public Health and Community Medicine
Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 1491-1500
Language en
Keywords androgens, cohort studies, insulin resistance, pre-diabetes, prospective studies, sex hormones, hormone-binding globulin, gastric bypass-surgery, middle-aged men, metabolic syndrome, androgen deficiency, glucose-metabolism, body-composition, sex-hormones, risk-factors, older men, Endocrinology & Metabolism
Subject categories Endocrinology


The objective of this study was to investigate whether there is a bidirectional association between testosterone concentrations and insulin resistance, in a prospective population study. A random population sample of 1400 men, aged 30-74, was examined in 2002-2005 in southwestern Sweden and followed up in 2012-2014 (N=657). After excluding subjects without information on sex hormones and insulin resistance, 1282 men were included in the baseline study. Fasting measurements of plasma glucose, insulin and hormones were performed. Insulin resistance was defined using HOMA-Ir. Mean age at baseline was 47.3 +/- 11.4 years. From the follow-up survey 546 men were included, mean age 57.7 +/- 11.6 years. Low concentrations of total testosterone at baseline were significantly associated with high IogHOMA-Ir at follow-up in a multivariable model including age, waist-hip ratio, physical activity, alcohol intake, smoking, LDL, CRP, hypertension, diabetes and logHOMA-Ir at baseline as covariates (beta = -0.096, P = 0.006). Similar results were observed for bioavailable testosterone. Men within the lowest quartile of total testosterone at baseline had significantly higher IogHOMA-Ir at follow-up than other quartiles (Q1 vs Q2 P = 0.008, Q1 vs Q3 P = 0.001, Q1 vs Q4 P = 0.052). Multivariable analysis of the impact of insulin resistance at baseline on testosterone levels at follow-up revealed no significant associations regarding testosterone concentrations (beta = -0.003, P = 0.928) or bioavailable testosterone (beta = -0.006, P = 0.873), when adjusting for baseline concentrations of total testosterone, age, waist-hip-ratio, LDL, CRP, physical activity, alcohol intake, smoking, hypertension and diabetes. Low testosterone concentrations at baseline predicted higher insulin resistance at follow-up, but high insulin resistance at baseline could not predict low testosterone at follow-up.

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