Insulin Resistance, Body Fat Distribution, and Sex Hormones in Men

Although many studies have suggested that increased androgenicity is associated with insulin resistance and hyperinsulinemia in both pre- and postmenopausal women, relatively few data are available on this relationship in men. We examined the association of body mass index (BMI), waist-to-hip ratio (WHR), sex hormone–binding globulin (SHBG), total and free testosterone, dehydroepiandrosterone sulfate (DHEA-SO₄), and estradiol with insulin concentrations and whole-body glucose disposal in 87 men from a population-based study in Kuopio, Finland. BMI was significantly correlated with fasting insulin (r = 0.46), total whole-body glucose disposal (r = −0.30), glucose oxidation (r = −0.21), and nonoxidative glucose disposal (r = −0.25). WHR also was significantly associated with fasting insulin (r = 0.61), total whole-body glucose disposal (r = −0.54), glucose oxidation (r = −0.23), and nonoxidative whole-body glucose disposal (r = −0.50). SHBG and total and free testosterone were significantly associated with insulin concentrations and total and nonoxidative glucose disposal but not with glucose oxidation. DHEA-SO₄ and estradiol were not associated with insulin, glucose concentrations, or whole-body glucose disposal in univariate analysis. In multivariate analysis, total whole-body glucose disposal was associated negatively with WHR and positively associated with total testosterone and SHBG; nonoxidative whole-body glucose disposal was associated negatively with WHR and positively associated with total and free testosterone. Glucose oxidation was significantly associated only with WHR. In conclusion, higher WHR and lower testosterone were strongly associated with a decrease in total and nonoxidative whole-body glucose disposal in men.