Although an association between the
metabolic syndrome and
hyperandrogenism has been suggested in women with
polycystic ovarian syndrome, few studies have investigated this relationship in postmenopausal women. We measured
estradiol,
testosterone, and
sex hormone-binding globulin (SHBG) and calculated the free
androgen index (FAI) in 212 postmenopausal women not using
hormone therapy in the Women's Health Study. A modified definition of the
metabolic syndrome (3 or more of the following:
abdominal obesity,
hypertriglyceridemia, low
high-density lipoprotein, elevated blood pressure, and abnormal
glucose metabolism) from the Third Report of the National
Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood
Cholesterol in Adults was used. Women with the
metabolic syndrome had higher mean levels of
estradiol,
testosterone, and FAI values and lower SHBG levels. Higher FAI and lower SHBG were associated with all components of the
metabolic syndrome. After adjustment for BMI and other factors, women in the highest tertile of FAI had an odds ratio of 12.6 (95% confidence interval, 3.8-41.6) for the
metabolic syndrome, whereas those in the lowest SHBG tertile had an odds ratio of 7.3 (95% confidence interval, 2.7-19.8). When stratified by body mass index, the associations with high FAI and low SHBG remained significant even in women with body mass index less than 26.7 kg/m2. An androgenic
hormone profile is associated with both the individual components of the
metabolic syndrome and clustering of metabolic abnormalities in postmenopausal women.