Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.
Eur J Prev Cardiol. 2013 Dec;20(6):1061-8. doi: 10.1177/2047487312452965. Epub 2012 Jun 18.
The aim of this study was to further evaluate the suggested independent association of sex hormone-binding globulin (SHBG) with incident metabolic syndrome (MetS) in men.
We used data from 1906 men aged 20-79 years from the population-based Study of Health in Pomerania (SHIP). Multivariable logistic regression models were implemented to analyse cross-sectional and longitudinal associations of total testosterone (TT), SHBG, and free testosterone (free T) concentrations with MetS. Furthermore, we associated changes between baseline and follow-up concentrations of TT, SHBG, and free T with incident MetS.
Cross-sectional logistic regression models revealed a significant inverse association of TT (odds ratio [OR] per standard deviation [SD] decrease: 1.28; 95% confidence interval (CI): 1.10-1.50), and free T (OR per SD decrease: 1.29; 95% CI: 1.11-1.51), but not SHBG (OR per SD decrease: 1.13; 95% CI: 0.98-1.30) with prevalent MetS. At the 5-year follow-up 1435 men were repeatedly examined and of the 956 men without baseline MetS, 328 men (34.3%) had incident MetS. Longitudinal analyses showed, after adjustment for the respective sex hormone, that lower baseline SHBG (OR per SD decrease: 1.30; 95% CI: 1.03-1.65), but not TT (OR per SD decrease: 1.14; 95% CI: 0.93-1.39) was associated with incident MetS. Change analyses revealed an inverse association between TT change and incident MetS (OR per SD decrease between baseline and follow-up: 1.19; 95% CI: 1.01-1.39), independent of SHBG; whereas SHBG change was not associated with incident MetS until adjustment for TT.
Although baseline SHBG predicts incident MetS independent of testosterone, change analyses suggest the testosterone decline as the main driver of the association between sex hormones and MetS.
本研究旨在进一步评估性激素结合球蛋白 (SHBG) 与男性代谢综合征 (MetS) 发病风险的独立相关性。
我们使用了来自基于人群的波罗的海健康研究 (SHIP) 的 1906 名 20-79 岁男性的数据。采用多变量逻辑回归模型分析总睾酮 (TT)、SHBG 和游离睾酮 (free T) 浓度与 MetS 的横断面和纵向相关性。此外，我们还将 TT、SHBG 和 free T 浓度在基线和随访之间的变化与新发 MetS 相关联。
横断面逻辑回归模型显示 TT（每标准差 [SD] 降低的比值比 [OR]：1.28；95%置信区间 [CI]：1.10-1.50）和 free T（OR 每 SD 降低：1.29；95% CI：1.11-1.51）与现患 MetS 呈显著负相关，而 SHBG（OR 每 SD 降低：1.13；95% CI：0.98-1.30）则无此相关性。在 5 年随访时，1435 名男性被重复检查，在 956 名无基线 MetS 的男性中，有 328 名（34.3%）发生了 MetS。纵向分析显示，在调整相应性激素后，基线时较低的 SHBG（OR 每 SD 降低：1.30；95% CI：1.03-1.65），而不是 TT（OR 每 SD 降低：1.14；95% CI：0.93-1.39）与新发 MetS 相关。变化分析显示，TT 变化与新发 MetS 呈负相关（SD 降低的比值比：1.19；95% CI：1.01-1.39），独立于 SHBG；而 SHBG 变化与新发 MetS 无关，直到调整 TT 后才相关。
尽管基线 SHBG 预测独立于睾酮的新发 MetS，但变化分析表明，睾酮下降是性激素与 MetS 之间关联的主要驱动因素。
