Heald Adrian, Laing Ian, McLernon David J, Donn Rachelle, Hartland Andrew J, Fryer Anthony A, Livingston Mark
Department of Medicine, Leighton Hospital, Crewe, United Kingdom.
School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom.
Open Biochem J. 2017 Mar 13;11:1-7. doi: 10.2174/1874091X01711010001. eCollection 2017.
Sex hormone binding globulin (SHBG) is a marker of insulin resistance. Given established links between BMI and socioeconomic disadvantage, we investigated how SHBG varies by index of multiple deprivation (IMD).
Using laboratory data from a Midlands UK population of mixed ethnicity, we examined the relation between blood concentrations of SHBG and IMD in 1160 women aged between 17 and 71 years. Women with a serum SHBG >250 nmol/L were excluded.
Mean age was 28.7 (95% confidence interval (CI) 28.2-29.1) years. 48.2% of women were of Caucasian origin, 15.5% of Southern Asian ethnicity and 2.6% were of African or other origin (33.7% were of unknown origin). SHBG increased with age (Spearman's ρ=0.195; p<0.001). A higher proportion of women of South Asian origin other ethnic groups had an SHBG <30 nmol/L (OR 1.93 (95% CI 1.37-2.71)). SHBG level was lower in individuals with greater socioeconomic disadvantage as measured by IMD (Spearman's ρ= -0.09; p=0.004 for SHBG IMD). In multivariate logistic regression, IMD women in the quartiles 2-5 (higher socioeconomic disadvantage) were more likely to have an SHBG <30 nmol/L (compatible with significant insulin resistance) quartile 1 (odds ratio (OR) 1.71 (95% confidence interval (CI) 1.17-2.53), adjusted for age (OR=0.97 (95% CI 0.95-0.98)) and ethnicity (for South Asian ethnicity OR=2.00 (95% CI 1.42-2.81) the rest).
Lower SHBG levels in women are associated with a higher level of socioeconomic disadvantage. Given the known association between lower SHBG and higher plasma glucose, our findings suggest a link between socioeconomic disadvantage and future risk of type 2 diabetes.
性激素结合球蛋白（SHBG）是胰岛素抵抗的一个标志物。鉴于体重指数（BMI）与社会经济劣势之间已确立的联系，我们研究了SHBG如何随多重剥夺指数（IMD）而变化。
利用来自英国中部一个混合种族人群的实验室数据，我们在1160名年龄在17至71岁之间的女性中研究了SHBG血浓度与IMD之间的关系。血清SHBG>250 nmol/L的女性被排除。
平均年龄为28.7岁（95%置信区间（CI）28.2 - 29.1）。48.2%的女性为白种人血统，15.5%为南亚族裔，2.6%为非洲或其他族裔（33.7%族裔不明）。SHBG随年龄增加而升高（斯皮尔曼等级相关系数ρ = 0.195；p<0.001）。与其他族裔群体相比，更高比例的南亚裔女性SHBG<30 nmol/L（比值比（OR）1.93（95% CI 1.37 - 2.71））。以IMD衡量，社会经济劣势更大的个体SHBG水平更低（SHBG与IMD的斯皮尔曼等级相关系数ρ = -0.09；p = 0.004）。在多因素逻辑回归中，处于第2 - 5四分位数（社会经济劣势更高）的女性比处于第1四分位数的女性更有可能SHBG<30 nmol/L（与显著的胰岛素抵抗相符）（比值比（OR）1.71（95%置信区间（CI）1.17 - 2.53），经年龄调整（OR = 0.97（95% CI 0.95 - 0.98））和族裔调整（南亚族裔OR = 2.00（95% CI 1.42 - 2.81），其他族裔OR为其余值）。
女性中较低的SHBG水平与较高程度的社会经济劣势相关。鉴于较低的SHBG与较高的血糖之间已知的关联，我们的研究结果提示社会经济劣势与未来2型糖尿病风险之间存在联系。
