Goedecke Julia H, Kufe Clement Nyuyki, Masemola Maphoko, Lichaba Mamosilo, Seipone Ikanyeng D, Mendham Amy E, Gibson Hylton, Hawley James M, Selva David M, Magodoro Itai M, Kengne Andre Pascal, Chikowore Tinashe, Crowther Nigel J, Norris Shane A, Karpe Fredrik, Olsson Tommy, Storbeck Karl-Heinz, Micklesfield Lisa K
Biomedical Research and Innovation Platform, South African Medical Research Council, Cape Town, South Africa.
South African Medical Research Council/WITS Developmental Pathways for Health Research Unit (DPHRU), Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
J Clin Endocrinol Metab. 2025 Apr 28. doi: 10.1210/clinem/dgaf256.
Sex hormone-binding globulin (SHBG) and testosterone are differentially associated with type 2 diabetes (T2D) risk.
To investigate whether the associations between SHBG, testosterone and T2D risk differ by HIV and menopausal status in Black African women living with (WH) and without HIV (WOH).
Cross-sectional observational.
Health Research Unit in Soweto, Johannesburg, South Africa.
81 premenopausal (57 WOH, 24 WH) and 280 postmenopausal (236 WOH, 44 WH) women from the Middle-Aged Soweto Cohort (MASC).
Circulating SHBG and sex hormones, body composition (dual energy x-ray absorptiometry), insulin sensitivity (Matsuda index), secretion (insulinogenic index, IGI) and clearance, and beta-cell function (disposition index, DI). Dysglycaemia was defined as either impaired fasting or postprandial glucose or T2D.
SHBG was higher and total and free testosterone were lower in postmenopausal WH than WOH (all p<0.023). Irrespective of HIV serostatus, SHBG was positively associated with Matsuda index, insulin clearance and DI and inversely with HOMA-IR (all p<0.011). The association between SHBG and Matsuda index was stronger in premenopausal than postmenopausal women (p=0.043 for interaction). Free testosterone (and not total testosterone) was only negatively associated with basal insulin clearance (p=0.021), and positively associated with HOMA-IR in premenopausal and not post-menopausal women (p=0.015 for interaction).
We show for the first time that midlife African WH have higher SHBG and lower total and free testosterone than WOH, which corresponded to their higher beta-cell function, suggesting a putative protective effect of SHBG on T2D risk in WH.
性激素结合球蛋白（SHBG）和睾酮与2型糖尿病（T2D）风险存在不同关联。
调查在感染HIV和未感染HIV的非洲黑人女性中，SHBG、睾酮与T2D风险之间的关联是否因HIV和绝经状态而异。
横断面观察性研究。
南非约翰内斯堡索韦托的健康研究单位。
来自索韦托中年队列（MASC）的81名绝经前女性（57名未感染HIV，24名感染HIV）和280名绝经后女性（236名未感染HIV，44名感染HIV）。
循环SHBG和性激素、身体成分（双能X线吸收法）、胰岛素敏感性（松田指数）、分泌（胰岛素生成指数，IGI）和清除率，以及β细胞功能（处置指数，DI）。血糖异常定义为空腹血糖受损或餐后血糖受损或T2D。
绝经后感染HIV的女性的SHBG较高，总睾酮和游离睾酮较低，而未感染HIV的女性则相反（所有p<0.023）。无论HIV血清学状态如何，SHBG与松田指数、胰岛素清除率和DI呈正相关，与HOMA-IR呈负相关（所有p<0.011）。绝经前女性中SHBG与松田指数之间的关联比绝经后女性更强（交互作用p=0.043）。游离睾酮（而非总睾酮）仅与基础胰岛素清除率呈负相关（p=0.021），在绝经前女性中与HOMA-IR呈正相关，而在绝经后女性中则不然（交互作用p=0.015）。
我们首次表明，中年非洲感染HIV的女性比未感染HIV的女性具有更高的SHBG和更低的总睾酮和游离睾酮，这与她们更高的β细胞功能相对应，表明SHBG对感染HIV女性的T2D风险具有潜在保护作用。
