Haffner S M, Valdez R A, Morales P A, Hazuda H P, Stern M P
Department of Medicine, University of Texas Health Science Center, San Antonio 78284-7873.
J Clin Endocrinol Metab. 1993 Jul;77(1):56-60. doi: 10.1210/jcem.77.1.8325960.
Sex hormones may influence risk factors for noninsulin-dependent diabetes mellitus (NIDDM). Decreased sex hormone-binding globulin (SHBG; an indirect measure of androgenicity) is associated with hyperinsulinemia and insulin resistance. We measured SHBG concentrations in 58 subjects who later converted to diabetes and 107 subjects who remained normoglycemic throughout the 8 yr of follow-up of the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Among premenopausal women, SHBG concentrations (nanomoles per L) were significantly lower in converters than in nonconverters (41.6 +/- 12.4 vs. 74.4 +/- 10.0; P = 0.004), but corresponding differences were not observed in postmenopausal women or in men. Since, however, analysis of variance suggested no significant interaction between menopausal status and conversion to NIDDM, we pooled pre- and postmenopausal women. Subsequent analysis indicated that SHBG concentrations predicted the development of NIDDM in women independently of glucose and insulin concentrations. We conclude that increased androgenicity, as assessed by decreased SHBG concentrations, is an important independent risk factor for NIDDM in women.
性激素可能会影响非胰岛素依赖型糖尿病（NIDDM）的危险因素。性激素结合球蛋白（SHBG；雄激素活性的间接指标）水平降低与高胰岛素血症及胰岛素抵抗相关。在圣安东尼奥心脏研究（一项基于人群的糖尿病和心血管疾病研究）为期8年的随访中，我们测量了58名后来转变为糖尿病的受试者以及107名始终保持血糖正常的受试者的SHBG浓度。在绝经前女性中，转变为糖尿病者的SHBG浓度（纳摩尔/升）显著低于未转变者（41.6±12.4 vs. 74.4±10.0；P = 0.004），但在绝经后女性或男性中未观察到相应差异。然而，由于方差分析表明绝经状态与转变为NIDDM之间无显著交互作用，我们将绝经前和绝经后女性合并分析。随后的分析表明，SHBG浓度可独立于血糖和胰岛素浓度预测女性NIDDM的发生。我们得出结论，通过降低的SHBG浓度评估的雄激素活性增加是女性NIDDM的一个重要独立危险因素。
