Sternfeld Barbara, Liu Kiang, Quesenberry Charles P, Wang Hua, Jiang Sheng-Fang, Daviglus Martha, Fornage Myriam, Lewis Cora E, Mahan John, Schreiner Pamela J, Schwartz Stephen M, Sidney Stephen, Williams O Dale, Siscovick David S
Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA.
J Clin Endocrinol Metab. 2008 Jun;93(6):2158-65. doi: 10.1210/jc.2007-2203. Epub 2008 Mar 11.
Body mass index (BMI) is directly related to testosterone (total T and free T) and inversely to SHBG cross-sectionally, but little is known about how changes in body fat and androgen markers affect each other over time.
Participants included 969 White and Black women from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort, who were ages 18-30 at entry into the study and were pre- or perimenopausal 16 yr later at the time of the CARDIA Women's Study (CWS). Total T and SHBG were assayed from specimens drawn at the CWS examination and stored serum from the yr 2 and 10 CARDIA exams. Free T was calculated based on total T and SHBG. BMI and waist circumference were measured at yr 2, 10, and 16.
Despite clinically significant increases in BMI and waist circumference, total T and free T tended to decline, whereas SHBG remained relatively constant. BMI and waist circumference were directly correlated with free T and inversely correlated with SHBG in cross-sectional analyses. In longitudinal, multivariable analyses, an annualized increase in BMI was inversely related to a concurrent annualized decrease in SHBG (beta = -0.79 ng/dl, and se = 0.22 in Blacks; beta = -1.07 ng/dl; and se = 0.31 in Whites). However, early increases in BMI were not related to later decreases in SHBG.
Increases in adiposity are closely tied to decreases in SHBG, but changes in BMI and SHBG may occur concurrently rather than sequentially.
体重指数（BMI）与睾酮（总睾酮和游离睾酮）直接相关，与性激素结合球蛋白（SHBG）呈负相关，但对于体脂和雄激素标志物的变化如何随时间相互影响，人们了解甚少。
参与者包括来自青年动脉粥样硬化风险发展研究（CARDIA）队列的969名白种人和黑种女性，她们在研究开始时年龄为18 - 30岁，在CARDIA女性研究（CWS）时，16年后处于绝经前或围绝经期。在CWS检查时采集的标本以及来自CARDIA研究第2年和第10年检查时储存的血清中检测总睾酮和SHBG。游离睾酮根据总睾酮和SHBG计算得出。在第2年、第10年和第16年测量BMI和腰围。
尽管BMI和腰围在临床上有显著增加，但总睾酮和游离睾酮趋于下降，而SHBG相对保持稳定。在横断面分析中，BMI和腰围与游离睾酮直接相关，与SHBG呈负相关。在纵向多变量分析中，BMI的年化增加与同时期SHBG的年化下降呈负相关（黑人中β = -0.79 ng/dl，标准误 = 0.22；白人中β = -1.07 ng/dl，标准误 = 0.31）。然而，早期BMI的增加与后期SHBG的下降无关。
肥胖的增加与SHBG的下降密切相关，但BMI和SHBG的变化可能同时发生而非相继发生。
