性激素结合球蛋白与美国黑种人、西班牙裔和亚洲/太平洋岛裔绝经后妇女临床糖尿病风险的关系。
Sex hormone-binding globulin and risk of clinical diabetes in American black, Hispanic, and Asian/Pacific Islander postmenopausal women.
机构信息
Program on Genomics and Nutrition, Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA, USA.
出版信息
Clin Chem. 2012 Oct;58(10):1457-66. doi: 10.1373/clinchem.2012.193086. Epub 2012 Aug 20.
BACKGROUND
Recent prospective studies have shown a strong inverse association between sex hormone-binding globulin (SHBG) concentrations and risk of clinical diabetes in white individuals. However, it remains unclear whether this relationship extends to other racial/ethnic populations.
METHODS
We evaluated the association between baseline concentrations of SHBG and clinical diabetes risk in the Women's Health Initiative Observational Study. Over a median follow-up of 5.9 years, we identified 642 postmenopausal women who developed clinical diabetes (380 blacks, 157 Hispanics, 105 Asians) and 1286 matched controls (777 blacks, 307 Hispanics, 202 Asians).
RESULTS
Higher concentrations of SHBG at baseline were associated with a significantly lower risk of clinical diabetes [relative risk (RR), 0.15; 95% CI, 0.09-0.26 for highest vs lowest quartile of SHBG, adjusted for BMI and known diabetes risk factors]. The associations remained consistent within ethnic groups [RR, 0.19 (95% CI, 0.10-0.38) for blacks; RR, 0.17 (95% CI, 0.05-0.57) for Hispanics; and 0.13 (95% CI, 0.03-0.48) for Asians]. Adjustment for potential confounders, such as total testosterone (RR, 0.11; 95% CI, 0.07-0.19) or HOMA-IR (RR, 0.26; 95% CI, 0.14-0.48) did not alter the RR substantially. In addition, SHBG concentrations were significantly associated with risk of clinical diabetes across categories of hormone therapy use (never users: RR(per SD) = 0.42, 95% CI, 0.34-0.51; past users: RR(per SD) = 0.53;, 95% CI, 0.37-0.77; current users: RR(per SD) = 0.57; 95% CI, 0.46-0.69; P-interaction = 0.10).
CONCLUSIONS
In this prospective study of postmenopausal women, we observed a robust, inverse relationship between serum concentrations of SHBG and risk of clinical diabetes in American blacks, Hispanics, and Asians/Pacific Islanders. These associations appeared to be independent of sex hormone concentrations, adiposity, or insulin resistance.
背景
最近的前瞻性研究表明，性激素结合球蛋白（SHBG）浓度与白人临床糖尿病风险之间呈强负相关。然而，目前尚不清楚这种关系是否适用于其他种族/民族人群。
方法
我们评估了妇女健康倡议观察研究中基线 SHBG 浓度与临床糖尿病风险之间的关联。在中位随访 5.9 年期间，我们确定了 642 名患有临床糖尿病的绝经后妇女（380 名黑人，157 名西班牙裔，105 名亚洲人）和 1286 名匹配的对照者（777 名黑人，307 名西班牙裔，202 名亚洲人）。
结果
基线时 SHBG 浓度较高与临床糖尿病风险显著降低相关[相对风险（RR），0.15；95%CI，0.09-0.26，最高四分位与最低四分位 SHBG 相比，调整 BMI 和已知糖尿病危险因素]。这种关联在不同种族群体中仍然一致[黑人的 RR 为 0.19（95%CI，0.10-0.38）；西班牙裔的 RR 为 0.17（95%CI，0.05-0.57）；亚洲人的 RR 为 0.13（95%CI，0.03-0.48）]。调整潜在混杂因素，如总睾酮（RR，0.11；95%CI，0.07-0.19）或 HOMA-IR（RR，0.26；95%CI，0.14-0.48），并未显著改变 RR。此外，SHBG 浓度与激素治疗使用类别的临床糖尿病风险显著相关（从未使用者：RR（每 SD）=0.42，95%CI，0.34-0.51；过去使用者：RR（每 SD）=0.53，95%CI，0.37-0.77；当前使用者：RR（每 SD）=0.57，95%CI，0.46-0.69；P 交互=0.10）。
结论
在这项对绝经后妇女的前瞻性研究中，我们观察到美国黑人、西班牙裔和亚洲/太平洋岛民的血清 SHBG 浓度与临床糖尿病风险之间存在稳健、负相关关系。这些关联似乎独立于性激素浓度、肥胖或胰岛素抵抗。
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