性激素结合球蛋白和睾酮水平作为绝经后女性2型糖尿病风险标志物的研究
Sex Hormone-Binding Globulins and Testosterone Levels as a Risk Marker for Type 2 Diabetes Mellitus among Postmenopausal Women.
作者信息
Saikia Uma K, Jabbar P K, Das Darvin V
机构信息
Department of Endocrinology, Guahati Medical College, Guwahati, Assam, India.
Department of Endocrinology, Medical College, Thiruvananthapuram, Kerala, India.
出版信息
J Midlife Health. 2021 Apr-Jun;12(2):155-160. doi: 10.4103/jmh.JMH_142_20. Epub 2021 Jul 27.
BACKGROUND
Endogenous sex hormones and sex hormone-binding globulins (SHBG) determine the risk of occurrence of Type 2 diabetes mellitus (T2DM) in postmenopausal (PM) women.
AIMS
To investigate the association between sex hormones (estradiol and testosterone) and SHBG with plasma glucose, fasting insulin levels, HbA1c, and homeostasis model assessment insulin resistance (HOMA-IR) and also to investigate independent role of sex hormones in the occurrence of T2DM among PM.
SETTINGS AND DESIGN
Cross-sectional case-control study.
SUBJECTS AND METHODS
The present study was conducted in Endocrinology department Guwahati, Medical College, Assam, India. The participants included cases - PM women with T2DM ( = 100) and controls - Healthy PM women ( = 86). The medical history, clinical examination, and investigations including total testosterone, serum estradiol, SHBG, free testosterone index, high sensitivity C-reactive protein (hs-CRP), lipid profile, fasting insulin, fasting plasma glucose (FPG), and postprandial plasma glucose (PPPG) were done and analyzed. HOMA-IR was calculated.
STATISTICAL ANALYSIS
Pearson correlation between sex hormone level and SHBG with plasma glucose, HbA1c, fasting insulin, hs-CRP, and HOMA-IR was seen. Multivariance logistic analysis was done to find the independent association between sex hormones/SHBG and the occurrence of T2 DM. P < 0.05 was considered statistically significant.
RESULTS
Among the cases, a significant positive correlation was found between total testosterone/free testosterone index with waist circumference, FPG PPPG, HbA1c, fasting insulin, and HOMA-IR, and a significant negative correlation was found between SHBG and FPG, PPPG, HbA1c, fasting insulin, and HOMA-IR ( < 0.01). The logistic analysis showed total testosterone levels and SHBG are independently associated with the occurrence of T2 DM among PM ( < 0.01).
CONCLUSION
SHBG and testosterone levels in PM can be a risk marker for the development of T2DM.
背景
内源性性激素和性激素结合球蛋白（SHBG）决定绝经后（PM）女性患2型糖尿病（T2DM）的风险。
目的
研究性激素（雌二醇和睾酮）及SHBG与血糖、空腹胰岛素水平、糖化血红蛋白（HbA1c）和稳态模型评估胰岛素抵抗（HOMA-IR）之间的关联，并研究性激素在PM女性发生T2DM中的独立作用。
设置与设计
横断面病例对照研究。
研究对象与方法
本研究在印度阿萨姆邦古瓦哈蒂医学院内分泌科进行。参与者包括病例组——患有T2DM的PM女性（n = 100）和对照组——健康的PM女性（n = 86）。进行并分析了病史、临床检查以及包括总睾酮、血清雌二醇、SHBG、游离睾酮指数、高敏C反应蛋白（hs-CRP）、血脂谱、空腹胰岛素、空腹血糖（FPG）和餐后血糖（PPPG）在内的检查。计算了HOMA-IR。
统计分析
观察了性激素水平和SHBG与血糖、HbA1c、空腹胰岛素、hs-CRP和HOMA-IR之间的Pearson相关性。进行多变量逻辑分析以发现性激素/SHBG与T2DM发生之间的独立关联。P < 0.05被认为具有统计学意义。
结果
在病例组中，总睾酮/游离睾酮指数与腰围、FPG、PPPG、HbA1c、空腹胰岛素和HOMA-IR之间存在显著正相关，而SHBG与FPG、PPPG、HbA1c、空腹胰岛素和HOMA-IR之间存在显著负相关（P < 0.01）。逻辑分析表明，总睾酮水平和SHBG与PM女性中T2DM的发生独立相关（P < 0.01）。
结论
PM女性中的SHBG和睾酮水平可能是T2DM发生的风险标志物。
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