Laing I, Olukoga A O, Gordon C, Boulton A J
Department of Clinical Biochemistry, Manchester Royal Infirmary, UK.
Diabet Med. 1998 Jun;15(6):473-9. doi: 10.1002/(SICI)1096-9136(199806)15:6<473::AID-DIA607>3.0.CO;2-L.
This study examined the relationship of hepatic and peripheral insulin sensitivity and beta-cell secretory function with serum sex hormone-binding globulin (SHBG) in men and women with Type 2 diabetes mellitus (DM). Fasting insulin, glucose and SHBG were measured in 58 Type 2 diabetic patients of both sexes (36 men) who were on diet treatment only and terms for insulin sensitivity and beta-cell secretion obtained by modelling. There was no significant difference in SHBG between men and women despite similar degree of obesity. SHBG was positively correlated (r = 0.41, p < 0.01) to hepatic insulin sensitivity derived from mathematical modelling of fasting glucose and insulin data using the homeostasis assessment model (HOMA). This relationship was independent of gender (men, r = 0.48, p < 0.01; women, r = 0.45, p < 0.05). Fasting insulin correlated negatively with SHBG in men (r = -0.34, p < 0.05). There were also significant negative correlations between SHBG and either plasma glucose (r = -0.29, p < 0.05) or body mass index (r = -0.34, p < 0.05). SHBG did not correlate with HOMA-modelled beta-cell function. In a multiple regression analysis, SHBG was independently correlated only with insulin sensitivity (p < 0.05). Further studies in 15 of the diabetic patients (11 men), showed a significant positive correlation (r = 0.52, p < 0.05) between SHBG and peripheral insulin sensitivity derived by continuous infusion of glucose with model assessment (CIGMA) but not between SHBG and CIGMA-modelled beta-cell function. These results indicate that both hepatic and peripheral insulin sensitivity are similarly related to serum SHBG in Type 2 diabetes of both sexes. The sex-difference in SHBG was abolished in the patients.
本研究调查了2型糖尿病（DM）男性和女性患者肝脏及外周胰岛素敏感性、β细胞分泌功能与血清性激素结合球蛋白（SHBG）之间的关系。对58例仅接受饮食治疗的2型糖尿病患者（36例男性）进行空腹胰岛素、血糖和SHBG检测，并通过建模得出胰岛素敏感性和β细胞分泌指标。尽管男女肥胖程度相似，但SHBG水平并无显著差异。使用稳态模型评估（HOMA）对空腹血糖和胰岛素数据进行数学建模，得出SHBG与肝脏胰岛素敏感性呈正相关（r = 0.41，p < 0.01）。这种关系不受性别影响（男性，r = 0.48，p < 0.01；女性，r = 0.45，p < 0.05）。男性空腹胰岛素与SHBG呈负相关（r = -0.34，p < 0.05）。SHBG与血糖（r = -0.29，p < 0.05）或体重指数（r = -0.34，p < 0.05）之间也存在显著负相关。SHBG与HOMA模型的β细胞功能无关。在多元回归分析中，SHBG仅与胰岛素敏感性独立相关（p < 0.05）。对15例糖尿病患者（11例男性）的进一步研究表明，通过葡萄糖持续输注模型评估（CIGMA）得出SHBG与外周胰岛素敏感性呈显著正相关（r = 0.52，p < 0.05），但SHBG与CIGMA模型的β细胞功能无关。这些结果表明，在2型糖尿病患者中，肝脏和外周胰岛素敏感性与血清SHBG的关系相似。患者中SHBG的性别差异消失。
