The Role of Endogenous Sex Hormones in the Development of Type 2 Diabetes
Hormonal balance is recognized as a factor in the development of non-communicable diseases, such as type 2 diabetes. The topic is of particular interest regarding the health of peri- and post-menopausal women who experience changes in hormone levels during the menopausal transition and also have increased risk of developing non-communicable diseases, such as cardiovascular disease and diabetes, as they age.
It is known that post-menopausal women have elevated glucose and elevated insulin response, compared to adiposity-matched pre-menopausal women, so it is possible that changes in the levels of specific sex hormones due to the menopausal transition play a role in increasing women’s risk of developing diabetes. Glucose and insulin response increased following a glucose challenge in ERα-knockout mice, mice lacking functional estrogen receptor-α, mice which can serve as a useful model for humans for endocrine research and the role of estrogen on the body. These results indicate that ERα is important for regulating adipose tissue in women. Furthermore, in an eight-year longitudinal cohort study, the Study of Women’s Health Across the Nation (SWAN), women who experienced vasomotor symptoms like hot flashes during the menopausal transition had a higher HOMA index, a measure of insulin resistance, and somewhat higher glucose than those who did not experience vasomotor symptoms. Additionally, as women experience the menopausal transition, they often gain subcutaneous abdominal fat and may also have a significant increase in visceral and subcutaneous abdominal fat, accompanied by a decrease in fat oxidation, all of which may predispose post-menopausal women to obesity, more frequent vasomotor symptoms, elevated glucose, elevated insulin response, and diabetes.
