Seipone Ikanyeng D, Mendham Amy E, Storbeck Karl-Heinz, Oestlund Imken, Kufe Clement N, Chikowore Tinashe, Masemola Maphoko, Crowther Nigel J, Kengne Andre Pascal, Norris Shane, Olsson Tommy, Brown Todd, Micklesfield Lisa K, Goedecke Julia H
Biomedical Research Innovation Platform, South African Medical Research Council, Cape Town 7505, South Africa.
Riverland Academy of Clinical Excellence, Riverland Mallee Coorong Local Health Network, South Australia Health, Berri, SA 5343, Australiacountry.
J Endocr Soc. 2024 Jul 19;8(8):bvae129. doi: 10.1210/jendso/bvae129. eCollection 2024 Jul 1.
To investigate longitudinal changes in SHBG and free testosterone (free T) levels among Black middle-aged African men, with and without coexistent HIV, and explore associations with incident dysglycaemia and measures of glucose metabolism.
This longitudinal study enrolled 407 Black South African middle-aged men, comprising primarily 322 men living without HIV (MLWOH) and 85 men living with HIV (MLWH), with normal fasting glucose at enrollment. Follow-up assessments were conducted after 3.1 ± 1.5 years.
At baseline and follow-up, SHBG, albumin, and total testosterone were measured and free T was calculated. An oral glucose tolerance test at follow-up determined dysglycaemia (impaired fasting glucose, impaired glucose tolerance, type 2 diabetes) and glucose metabolism parameters including insulin sensitivity (Matsuda index), insulin resistance (homeostasis model assessment of insulin resistance), and beta(β)-cell function (disposition index). The primary analysis focussed on MLWOH, with a subanalysis on MLWH to explore whether associations in MLWOH differed from MLWH.
The prevalence of dysglycaemia at follow-up was 17% (n = 55) in MLWOH. Higher baseline SHBG was associated with a lower risk of incident dysglycaemia (odds ratio 0.966; 95% confidence interval 0.945-0.987) and positively associated with insulin sensitivity (β = 0.124, < .001) and β-cell function (β = 0.194, = .001) at follow-up. Free T did not predict dysglycaemia. In MLWH, dysglycaemia prevalence at follow-up was 12% (n = 10). Neither baseline SHBG nor free T were associated with incident dysglycaemia and glucose metabolism parameters in MLWH.
SHBG levels predict the development of dysglycaemia in middle-aged African men but do not exhibit the same predictive value in MLWH.
调查有无合并感染艾滋病毒的非洲裔黑人中年男性血清性激素结合球蛋白（SHBG）和游离睾酮（游离T）水平的纵向变化，并探讨其与新发血糖异常及糖代谢指标之间的关联。
这项纵向研究纳入了407名南非黑人中年男性，主要包括322名未感染艾滋病毒的男性（MLWOH）和85名感染艾滋病毒的男性（MLWH），入组时空腹血糖正常。随访评估在3.1±1.5年后进行。
在基线和随访时，测量SHBG、白蛋白和总睾酮水平，并计算游离T。随访时进行口服葡萄糖耐量试验以确定血糖异常（空腹血糖受损、糖耐量受损、2型糖尿病）以及糖代谢参数，包括胰岛素敏感性（松田指数）、胰岛素抵抗（胰岛素抵抗稳态模型评估）和β细胞功能（处置指数）。主要分析集中在MLWOH组，并对MLWH组进行亚组分析，以探讨MLWOH组中的关联是否与MLWH组不同。
随访时，MLWOH组血糖异常的患病率为17%（n = 55）。较高的基线SHBG水平与较低的新发血糖异常风险相关（比值比0.966；95%置信区间0.945 - 0.987），并且与随访时的胰岛素敏感性呈正相关（β = 0.124，P <.001）以及β细胞功能呈正相关（β = 0.194，P =.001）。游离T不能预测血糖异常。在MLWH组中，随访时血糖异常的患病率为12%（n = 10）。在MLWH组中，基线SHBG和游离T均与新发血糖异常及糖代谢参数无关。
SHBG水平可预测非洲裔中年男性血糖异常的发生，但在MLWH组中不具有相同的预测价值。
