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How Do Estrone Levels Affect Men and Their Risk for Diabetes?

Jan 23, 2014

The relationship of estradiol and estrone to diabetes in men is examined…. 

There is an association between aging and a decline in glucose tolerance resulting in a higher prevalence of type 2 diabetes in older adults. Furthermore, an age-related decline in testosterone levels has been associated with an increased risk of type 2 diabetes in older men. In postmenopausal women, the administration of estrogen has reduced the risk of diabetes. While good news for women, the relationship between estradiol levels and type 2 diabetes in men is not fully understood due to not only a lack of studies on the subject, but also the presence of conflicting data from said studies. When it comes to estrone and type 2 diabetes in men, no studies have been performed to establish the relationship between the two. This particular study uses data from the Framingham Offspring Study to determine whether circulating estrone and estradiol levels are associated with type 2 diabetes or impaired fasting glucose in community-dwelling older men.

A cross-sectional study was performed using the subjects of the Framingham Offspring Study cohort who attended examination 7, while a longitudinal analysis of type 2 diabetes incidence was performed using subjects of examination 8. Examination 7 took place from 1998-2001 while examination 8 took place in 2005-2008. A total of 1,458 subjects from examination 7 and 1,031 subjects from examination 8 were studied for these analyses. Subjects were considered to have type 2 diabetes if their fasting blood glucose levels exceeded 125 mg/dl or if they reported use of diabetic medications. Serum estradiol and estrone levels were measured using a highly sensitive LC-MS/MS assay. The results of these studies show that there was a general pattern of an increase in prevalence of type 2 diabetes with both estrone and estradione levels in already existing cases of diabetes. Analysis of the examination 8 group have shown an association between estrone concentrations and incident type 2 diabetes, with a linear trend towards an increase in incidence type 2 diabetes and total estrone levels.

In conclusion, elevated estrone and estradiol levels were associated with existing type 2 diabetes in a cohort of men. However, there is a lack of significant association between estradiol and incident type 2 diabetes. Only estrone levels were predictive of incident type 2 diabetes. The exact mechanism as to why estrone might contribute to type 2 diabetes should be investigated in future studies to better understand this association. In the meantime, estrone levels could potentially be used as a marker of diabetes risk in men.

Practice Pearls:
  • Estrone levels have the potential to be utilized as a marker of diabetes risk in men.
  • Higher estrone levels are associated with an increased risk of incident type 2 diabetes.
  • Estrone is a more sensitive marker of diabetes risk than is estradiol. 

Diabetes/Metabolism Research & Reviews 2014. Jasuja, G. K. et al. "Circulating Estrone Levels Are Associated Prospectively With Diabetes Risk in Men of the Framinghamn Study" Diabetes Care 36 (2013) 2591-2596