Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.
Center for Global Cardio-metabolic Health, Brown University, Providence, Rhode Island, USA.
J Diabetes. 2018 Jun;10(6):467-477. doi: 10.1111/1753-0407.12550. Epub 2017 May 14.
Low circulating levels of sex hormone-binding globulin (SHBG) have been shown to be a direct and strong risk factor for type 2 diabetes, cardiovascular diseases, and hormone-dependent cancers, although the relationship between various aspects of dietary carbohydrates and SHBG levels remains unexplored in population studies.
Among postmenopausal women with available SHBG measurements at baseline (n = 11 159) in the Women's Health Initiative, a comprehensive assessment was conducted of total dietary carbohydrates, glycemic load (GL), glycemic index (GI), fiber, sugar, and various carbohydrate-abundant foods in relation to circulating SHBG levels using multiple linear regressions adjusting for potential covariates. Linear trend was tested across quartiles of dietary variables. Benjamini and Hochberg's procedure was used to calculate the false discovery rate for multiple comparisons.
Higher dietary GL and GI (both based on total and available carbohydrates) and a higher intake of sugar and sugar-sweetened beverages were associated with lower circulating SHBG concentrations (all P < 0.05; Q -values = 0.04,0.01, 0.07, 0.10, 0.01, and <0.0001, respectively). In contrast, women with a greater intake of dietary fiber tended to have elevated SHBG levels (P = 0.01, Q -value = 0.04). There was no significant association between total carbohydrates or other carbohydrate-abundant foods and SHBG concentrations.
The findings suggest that low GL or GI diets with low sugar and high fiber content may be associated with higher serum SHBG concentrations among postmenopausal women. Future studies investigating whether lower GL or GI diets increase SHBG concentrations are warranted.
已有研究表明，循环性激素结合球蛋白（SHBG）水平较低是 2 型糖尿病、心血管疾病和激素依赖性癌症的直接且强有力的危险因素，尽管人群研究中仍未探索各种膳食碳水化合物与 SHBG 水平之间的关系。
在妇女健康倡议（Women's Health Initiative）中，对基线时（n=11159）可获得 SHBG 测量值的绝经后妇女进行了一项综合评估，使用多元线性回归调整潜在协变量，评估总膳食碳水化合物、血糖负荷（GL）、血糖指数（GI）、纤维、糖以及各种富含碳水化合物的食物与循环 SHBG 水平之间的关系。通过线性趋势检验对膳食变量的四分位间距进行分析。采用 Benjamini 和 Hochberg 程序计算多重比较的假发现率。
较高的膳食 GL 和 GI（基于总碳水化合物和可利用碳水化合物）以及较高的糖和含糖饮料摄入与较低的循环 SHBG 浓度相关（均 P < 0.05；Q 值分别为 0.04、0.01、0.07、0.10、0.01 和 <0.0001）。相反，膳食纤维摄入量较高的女性 SHBG 水平升高（P=0.01，Q 值=0.04）。总碳水化合物或其他富含碳水化合物的食物与 SHBG 浓度之间无显著相关性。
这些发现表明，低 GL 或 GI 饮食、低糖、高纤维含量可能与绝经后妇女的血清 SHBG 浓度升高有关。需要进一步研究低 GL 或 GI 饮食是否会增加 SHBG 浓度。
