Čulić Viktor, Bušić Željko, Vio Riccardo, Mijić Tanni, Velat Ivan
Department of Cardiology and Angiology, University Hospital Centre Split, Šoltanska 1, 21000 Split, Croatia.
School of Medicine, University of Split, Šoltanska 2A, 21000 Split, Croatia.
J Clin Med. 2025 Mar 21;14(7):2132. doi: 10.3390/jcm14072132.
The association of sex hormone-binding globulin (SHBG) with heart failure (HF) remains a topic of ongoing debate, particularly in the light of type 2 diabetes mellitus (T2DM). We aimed to assess the association of SHBG with clinical and echocardiographic parameters of HF in men according to the presence of T2DM. : Data on baseline characteristics, cardiovascular risk factors and medications, laboratory findings including serum SHBG and total testosterone concentrations, and echocardiographic parameters were prospectively collected for 215 male patients consecutively hospitalized for an acute episode of HF. : Patients with T2DM were older ( = 0.013), had a greater body mass index ( = 0.009) and NYHA class ( = 0.001), and were more likely to have hypertension ( < 0.001) or hyperlipidemia ( = 0.032). A moderate correlation among SHBG and total testosterone with the left ventricular ejection fraction (LVEF) was observed only in T2DM patients (r = 0.456) but not among non-T2DM patients (r = 0.194). A multivariate analysis revealed the independent association of increased SHBG levels with lower LVEF values among T2DM patients (ß = -0.542, < 0.0001), whereas in the same group higher total testosterone was an independent predictor of higher LVEF (ß = 0.531, < 0.0001) and lower LVDD (ß = -0.442, = 0.0002) levels. : In men with HF and T2DM, in contrast to testosterone, SHBG may have an independent adverse impact on the LVEF, which may account for 12.5% of the variance in LVEF levels. The possible subcellular mechanisms of SHBG in men with diabetic myocardial disorder should be additionally explored.
性激素结合球蛋白（SHBG）与心力衰竭（HF）之间的关联仍是一个持续争论的话题，尤其是鉴于2型糖尿病（T2DM）。我们旨在根据T2DM的存在情况评估男性中SHBG与HF的临床和超声心动图参数之间的关联。前瞻性收集了215例因HF急性发作而连续住院的男性患者的基线特征、心血管危险因素和用药情况、实验室检查结果（包括血清SHBG和总睾酮浓度）以及超声心动图参数。T2DM患者年龄更大（P = 0.013），体重指数更高（P = 0.009）且纽约心脏协会（NYHA）心功能分级更高（P = 0.001），并且更有可能患有高血压（P < 0.001）或高脂血症（P = 0.032）。仅在T2DM患者中观察到SHBG和总睾酮与左心室射血分数（LVEF）之间存在中度相关性（r = 0.456），而非T2DM患者中未观察到（r = 0.194）。多变量分析显示，T2DM患者中SHBG水平升高与较低的LVEF值独立相关（β = -0.542，P < 0.0001），而在同一组中，较高的总睾酮是较高LVEF（β = 0.531，P < 0.0001）和较低左心室舒张末期内径（LVDD）水平（β = -0.442，P = 0.0002）的独立预测因素。与睾酮相反，在患有HF和T2DM的男性中，SHBG可能对LVEF有独立的不利影响，这可能占LVEF水平方差的12.5%。应进一步探索SHBG在糖尿病性心肌病男性中的可能亚细胞机制。
