Akin Fulya, Bastemir Mehmet, Kaptanoglu Bunyamin
Department of Endocrinology and Metabolism, Pamukkale University Faculty of Medicine, Denizli, Turkey.
Ann Nutr Metab. 2007;51(6):557-62. doi: 10.1159/000114210. Epub 2008 Jan 28.
The aim of this study was to assess the impact of insulin sensitivity on the relationship between sex hormone-binding globulin (SHBG) and insulin levels during active weight loss in euthyroid obese women.
The study population comprised 80 premenopausal overweight and obese (BMI > or =27) women (mean age 41.44 +/- 10.03 years). Seventy patients were considered eligible for the study. Hypocaloric diets were given to all patients. Of 70 subjects who were initially willing to participate in the study, only 64 continued through to the last stage of the study.
Anthropometric parameters, metabolic markers and sex hormone status were measured at baseline and on completion of the 12-week study period.
Following the diet, significant decreases in insulin, homeostasis model assessment (HOMA) for insulin resistance and fasting glucose were noted. However, HOMA insulin secretion values did not change significantly. Interestingly, there was no significant correlation between SHBG and insulin levels at baseline. After weight loss, SHBG concentrations were significantly and negatively correlated with insulin levels. Therefore, it was concluded that, in severe insulin resistance, insulin does not inhibit the SHBG level. These findings could be important, but the authors have not found a similar relationship in the literature.
The findings of this study provide some clues to the relationship between insulin and SHBG in insulin-resistant obese subjects. Insulin sensitivity or loss of fat tissue or leptin seem to be involved in the relationship between SHBG and insulin.
本研究旨在评估甲状腺功能正常的肥胖女性在积极减重期间,胰岛素敏感性对性激素结合球蛋白(SHBG)与胰岛素水平之间关系的影响。
研究人群包括80名绝经前超重和肥胖(BMI≥27)女性(平均年龄41.44±10.03岁)。70名患者被认为符合研究条件。所有患者均采用低热量饮食。在最初愿意参与研究的70名受试者中,只有64名持续到研究的最后阶段。
在基线和12周研究期结束时测量人体测量参数、代谢指标和性激素状态。
饮食干预后,胰岛素、胰岛素抵抗的稳态模型评估(HOMA)和空腹血糖显著降低。然而,HOMA胰岛素分泌值没有显著变化。有趣的是,基线时SHBG与胰岛素水平之间没有显著相关性。体重减轻后,SHBG浓度与胰岛素水平显著负相关。因此,得出的结论是,在严重胰岛素抵抗时,胰岛素不会抑制SHBG水平。这些发现可能很重要,但作者在文献中未发现类似关系。
本研究结果为胰岛素抵抗肥胖受试者中胰岛素与SHBG之间的关系提供了一些线索。胰岛素敏感性、脂肪组织丢失或瘦素似乎参与了SHBG与胰岛素之间的关系。