Haffner S M, Dunn J F, Katz M S
Division of Clinical Epidemiology, University of Texas Health Science Center, San Antonio 78284-7873.
Metabolism. 1992 Mar;41(3):278-84. doi: 10.1016/0026-0495(92)90271-b.
Sex hormones play a major role in determining the risk of cardiovascular disease. While several studies have shown that reduced sex hormone-binding globulin (SHBG) is associated with increased insulin and triglyceride and decreased high-density lipoprotein cholesterol (HDLC) in premenopausal women, little data are available for postmenopausal women. We hypothesized that in postmenopausal women decreased SHBG would be associated with an atherogenic pattern of cardiovascular risk factors. We measured SHBG, lipids, lipoproteins, glucose, and insulin concentrations, and systolic and diastolic blood pressure in 101 postmenopausal women. SHBG was negatively associated with triglyceride (r = -.21) and insulin (r = -.47) concentrations and positively associated with HDLC concentrations (r = .47). After adjustment for overall adiposity (body mass index) and upper body adiposity (as measured by the ratio of waist to hip circumferences), SHBG was still associated with HDLC and insulin, but not with triglyceride. Sex hormones were not related to systolic and diastolic blood pressure. The results may help to explain an association of increased androgenicity, as measured by a lower SHBG concentration, with diabetes and risk of cardiovascular disease in older women.
性激素在决定心血管疾病风险方面起着主要作用。虽然多项研究表明，绝经前女性性激素结合球蛋白（SHBG）水平降低与胰岛素和甘油三酯升高以及高密度脂蛋白胆固醇（HDLC）降低有关，但绝经后女性的数据却很少。我们推测，在绝经后女性中，SHBG降低会与心血管危险因素的致动脉粥样硬化模式相关。我们测量了101名绝经后女性的SHBG、脂质、脂蛋白、葡萄糖和胰岛素浓度，以及收缩压和舒张压。SHBG与甘油三酯浓度（r = -0.21）和胰岛素浓度（r = -0.47）呈负相关，与HDLC浓度呈正相关（r = 0.47）。在对总体肥胖（体重指数）和上身肥胖（通过腰臀比测量）进行校正后，SHBG仍与HDLC和胰岛素相关，但与甘油三酯无关。性激素与收缩压和舒张压无关。这些结果可能有助于解释，以较低的SHBG浓度衡量的雄激素水平升高与老年女性糖尿病和心血管疾病风险之间的关联。
