Kopp H P, Festa A, Krugluger W, Schernthaner G
Department of Medicine 1, Rudolfstiftung Hospital, Juchgasse 25, A-1030 Vienna, Austria.
Exp Clin Endocrinol Diabetes. 2001;109(7):365-9. doi: 10.1055/s-2001-17408.
Low Sex-Hormone-Binding Globulin (SHBG) levels--indicating a state of hyperandrogenicity--are associated with a higher risk for the development of non-insulin dependent diabetes (NIDDM) in women and are accepted as a marker of muscular insulin resistance. To analyze whether low SHBG values are also present in patients with gestational diabetes, we investigated levels of SHBG in 42 patients with gestational diabetes mellitus (GDM) in comparison with 48 pregnant women with normal glucose tolerance (NGT). Beside maternal parameters like body-mass index (BMI), HbA1c, fasting, 1- and 2-hour blood glucose and insulin concentrations, parameters of the new-borns (head-circumference, body weight, height and sex) were recorded. Maternal and neonatal variables were then related to SHBG levels. Both groups showed no differences in BMI, height, weight or age of gestation. Patients with GDM revealed significantly lower levels of SHBG than pregnant women with NGT(512 +/- 249 nmol/l vs. 643 +/- 137 nmol/l; p < 0.01). In patients with severe GDM and insulin therapy significantly lower levels of SHBG than in those with dietary treatment only were found (223 +/- 210 nmol/l vs. 592 +/- 102 nmol/l; p < 0.001). SHBG was inversely correlated to BMI (r = - 0.30; p < 0.01), 1-hour (r = - 0.20; p < 0.05) and 2-hour blood glucose levels (r = - 0.30; p <0.01). In summary, we found significantly lower levels of SHBG in patients with GDM, especially in those who developed severe GDM and required insulin therapy during the last months of pregnancy.
低性激素结合球蛋白（SHBG）水平——表明存在高雄激素血症状态——与女性非胰岛素依赖型糖尿病（NIDDM）的发生风险较高相关，并且被认为是肌肉胰岛素抵抗的一个标志物。为了分析妊娠糖尿病患者是否也存在低SHBG值，我们调查了42例妊娠糖尿病（GDM）患者的SHBG水平，并与48例糖耐量正常（NGT）的孕妇进行比较。除了记录诸如体重指数（BMI）、糖化血红蛋白（HbA1c）、空腹血糖、1小时和2小时血糖及胰岛素浓度等母体参数外，还记录了新生儿的参数（头围、体重、身高和性别）。然后将母体和新生儿变量与SHBG水平相关联。两组在BMI、身高、体重或妊娠年龄方面均无差异。GDM患者的SHBG水平显著低于NGT孕妇（512±249 nmol/l对643±137 nmol/l；p<0.01）。在重度GDM且接受胰岛素治疗的患者中，发现其SHBG水平显著低于仅接受饮食治疗的患者（223±210 nmol/l对592±102 nmol/l；p<0.001）。SHBG与BMI呈负相关（r = - 0.30；p<0.01），与1小时（r = - 0.20；p<0.05）和2小时血糖水平呈负相关（r = - 0.30；p<0.01）。总之，我们发现GDM患者的SHBG水平显著较低，尤其是那些在妊娠最后几个月发展为重度GDM并需要胰岛素治疗的患者。
