Fenske Benjamin, Kische Hanna, Gross Stefan, Wallaschofski Henri, Völzke Henry, Dörr Marcus, Nauck Matthias, Keevil Brian G, Brabant Georg, Haring Robin
Institute of Clinical Chemistry and Laboratory Medicine (B.F., H.K. H.W., M.N., R.H.), DZHK (German Centre for Cardiovascular Research) (S.G., H.W., H.V., M.D., M.N., R.H.), Greifswald, Germany 17475, Institute for Community Medicine (H.V.), Department of Cardiology (S.G., M.D.), University Medicine Greifswald, Germany 17475; Department of Clinical Chemistry (B.G.K.), University Hospital, South Manchester, United Kingdom M23 9LT; Department of Internal Medicine I (G.B.), University Lübeck, Germany 23562; and European University of Applied Sciences (R.H.), Faculty of Applied Public Health, Rostock, Germany 18057.
J Clin Endocrinol Metab. 2015 Dec;100(12):4595-603. doi: 10.1210/jc.2015-2546. Epub 2015 Oct 7.
The association of endogenous androgens and sex hormone-binding globulin (SHBG) with metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM) mostly 23562 refers to small and selected study samples with immunoassay-based measurements. Thus, we investigated the association of hormone levels with MetS and T2DM in women from a large population-based sample.
DESIGN, SETTING, AND PARTICIPANTS: A total of 2077 women from the Study of Health in Pomerania were assessed at baseline (N = 3160, 1997-2001) and 5-year follow-up (N = 1711, 2002-2006).
We investigated associations of total testosterone (T) and androstenedione measured by liquid chromatography-tandem mass spectrometry, SHBG by immunoassay, and free T and free androgen index with MetS and T2DM.
Baseline prevalence of MetS and T2DM was 23.1% (N = 365) and 9.5% (N = 196), with an incidence of 17.7 and 7.0 per 1.000 person-years, respectively. Cross-sectional analyses yielded inverse associations of SHBG with MetS (relative risk [RR], 0.67; 95% confidence interval [CI], 0.60-0.74) and T2DM (RR, 0.61; 95% CI, 0.50-0.74) after multivariable adjustment. In longitudinal analyses, only age-adjusted models showed an inverse association of baseline SHBG with incident MetS (RR, 0.61; 95% CI, 0.51-0.73) and T2DM (RR, 0.58; 95% CI, 0.43-0.78). Multivariable-adjusted models stratified by menopausal status revealed an inverse association between SHBG and incident MetS risk in postmenopausal women (RR, 0.65; 95% CI, 0.51-0.81).
This longitudinal population-based study revealed independent inverse associations of SHBG with MetS and T2DM, suggesting low SHBG as a potential risk marker for cardiometabolic morbidity, especially among postmenopausal women.
内源性雄激素和性激素结合球蛋白（SHBG）与代谢综合征（MetS）及2型糖尿病（T2DM）的关联大多涉及基于免疫测定的小样本且经过挑选的研究。因此，我们在一个基于大规模人群的样本中调查了女性激素水平与MetS和T2DM的关联。
设计、地点与参与者：来自波美拉尼亚健康研究的总共2077名女性在基线期（N = 3160，1997 - 2001年）和5年随访期（N = 1711，2002 - 2006年）接受了评估。
我们通过液相色谱 - 串联质谱法测定总睾酮（T）和雄烯二酮，通过免疫测定法测定SHBG，并研究游离T和游离雄激素指数与MetS和T2DM的关联。
MetS和T2DM的基线患病率分别为23.1%（N = 365）和9.5%（N = 196），发病率分别为每1000人年17.7例和7.0例。横断面分析显示，在多变量调整后，SHBG与MetS（相对风险[RR]，0.67；95%置信区间[CI]，0.60 - 0.74）及T2DM（RR，0.61；95% CI，0.50 - 0.74）呈负相关。在纵向分析中，只有年龄调整模型显示基线SHBG与新发MetS（RR，0.61；95% CI，0.51 - 0.73）及T2DM（RR，0.58；95% CI,）呈负相关。按绝经状态分层的多变量调整模型显示，绝经后女性中SHBG与新发MetS风险呈负相关（RR，0.65；95% CI，0.51 - 0.81）。
这项基于人群的纵向研究揭示了SHBG与MetS和T2DM之间独立的负相关关系，提示低SHBG可能是心脏代谢疾病发病的潜在风险标志物，尤其是在绝经后女性中。
