This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Obesity  • Diabetes Mellitus  • Neurology  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Ding and colleagues¹ concluded that there are sex-specific etiologies of type 2 diabetes because diabetes mellitus is associated with relatively elevated testosterone levels in women while the reverse holds true for men. An alternate explanation is that visceral adiposity could be a primary factor that contributes to the development of insulin resistance, altered sex steroid and sex hormone–binding globulin (SHBG) production, and diabetes in both sexes.

In support of this view, abdominal obesity and elevated insulin levels precede development of male hypogonadism² and female hyperandrogenism.³ Excess adipose aromatase activity increases the conversion of testosterone to estradiol, leading to hypogonadotropic hypogonadism in obese men, which may be reversed by aromatase inhibition or weight loss. In women, elevated insulin levels related to visceral adiposity may promote the growth of ovarian steroidogenic tissue and excess androgen production.⁴ This sex-specific effect is due to the plasticity of ovarian steroidogenic theca-interstitial . . . [Full Text of this Article]

Carolyn A. Bondy, MD
bondyc@mail.nih.gov
National Institute of Child Health and Human Development
National Institutes of Health
Bethesda, Md

RELATED ARTICLES

Endogenous Sex Hormones and Type 2 Diabetes Risk
Gerald B. Phillips
JAMA. 2006;296(2):168-169.
EXTRACT | FULL TEXT  

Endogenous Sex Hormones and Type 2 Diabetes Risk—Reply
Eric L. Ding, Yiqing Song, and Simin Liu
JAMA. 2006;296(2):169-170.
EXTRACT | FULL TEXT  

Sex Differences of Endogenous Sex Hormones and Risk of Type 2 Diabetes: A Systematic Review and Meta-analysis
Eric L. Ding, Yiqing Song, Vasanti S. Malik, and Simin Liu
JAMA. 2006;295(11):1288-1299.
ABSTRACT | FULL TEXT