Sex hormone-binding globulin as a marker for hyperinsulinemia and/or insulin resistance in obese children (original) (raw)
Related papers
Endocrine Connections, 2012
Objectives: Obesity is associated with low levels of sex hormone-binding globulin (SHBG). While the reason is not fully understood, we aimed to study the association between serum Q2 insulin and levels of SHBG in a random population. Design and methods: Between 2001 and 2005, a random sample of 2816 participants aged 30-74 years were enrolled in a cross-sectional survey in the South-west of Sweden. Fasting blood samples were collected and an oral glucose tolerance test (OGTT) was conducted in all subjects without known diabetes. Diabetes mellitus was defined according to criteria from WHO, and clinical characteristics were used to discriminate between type 1 (T1D) and type 2 diabetes (T2D). Analyses of SHBG were successful in 2782 participants (98%), who thus constituted the current study population. Results: We found significant inverse association between levels of SHBG and fasting serum insulin in both genders (men: bZK0.090, PZ0.001; women: bZK0.197, P!0.001), which was independent of differences in age and BMI. The associations remained when also differences in fasting plasma glucose were accounted for (men: bZK0.062, PZ0.022; women: bZK0.176, P%0.001). Subjects with T1D exhibited higher levels of SHBG than both T2D (men: dZ15.9 nmol/l, P!0.001; women: dZ71.1 nmol/l, P!0.001) and non-diabetic subjects (men: dZ15.1 nmol/l, P!0.001; women: dZ72.9 nmol/l, P!0.001) independent of age, BMI and fasting glucose levels. Conclusion: These findings are consistent with high levels of SHBG in T1D, and correspondingly low levels in T2D subjects, suggesting an inhibitory effect of insulin on the SHBG production in the liver.
Archives of Andrology, 2006
The objective of this work was to evaluate the relationship between sex steroid hormones, sex hormone-binding-globulin, leptin, insulin and insulin resistance in obese men. Anthropometrical indexes, total testosterone (Tt), free testosterone (fT), estradiol (E), sex hormone-binding-globulin (SHBG), glucemia, insulin and leptin were measured in 77 men, with ages between 20 and 60 years. According to their body mass index (BMI), subjects were grouped into three categories: normal body weight (<24.9 kg=m 2), overweight (25-29,9 kg=m 2) and obese group (>30 kg=m 2). Insulin resistance index was obtained by the homeostasis assessment model for insulin resistance (HOMA-IR). Total testosterone and SHBG concentrations were lower in the obese group compared with normal and overweight subjects (p < 0.05). The mean insulin concentration was significantly higher in the obese group compared with the other groups (p < 0.05). T was negatively correlated with the BMI (r ¼ À0.447; p < .01), WC (r ¼ À0.464); p < .01, leptin (r ¼ À0.382; p < .01), insulin (r ¼ À0.391; p < 0.01) and also with the HOMA-IR (r ¼ À0.416; p < 0.01). The SHBG negatively and significantly correlated with BMI (r ¼ À0.334; p < 0.01) and WC index (¼ À0.322; p < 0.01), as well with insulin levels (r ¼ À0.313; p < 0.01) and insulin resistance (¼ À0.266; p < 0.05). Our results shows that in a sample of men, Tt and SHBG concentrations proportionally diminished with both the increase of BMI and insulin resistance index.
SEX HORMONE-BINDING GLOBULIN IN OBESE TYPE 2 DIABETES MELLITUS
Background: Diabetes Mellitus is recognized as a public health problem of pandemic proportions. Most patients with type 2 diabetes are obese with varying degrees of gender-related adiposity and fat tissue distribution. Obesity is a well-known indirect risk for type 2 diabetes because of its association with insulin resistance and consequent glycemic control impairment. Recently, a great concern was paid in respect to the role of Sex hormone–binding globulin (SHBG) and adipose tissue hormones in the development of insulin resistance, hyperlipidemia and type 2 diabetes. Previous studies suggested that serum sex hormone-binding globulin (SHBG) has a role in glucose homeostasis in both men and women and low levels are associated with development of diabetes, cardiovascular diseases, insulin resistance and hyperinsulinemia. Aim of the work: to determine the relationship between serum sex hormone-binding globulin, obesity, and metabolic parameters in type 2 diabetes in both sex. Methods: forty obese type 2 diabetic patients were selected and compared with ten obese non-diabetics as control. After complete examination; insulin level, fasting blood glucose, postprandial glucose, glycated hemoglobin (HbA1c), cholesterol, triglycerides and serum levels of sex hormone binding globulin were measured. Results: the mean SHBG concentration was lower in diabetic group (18.95±3.4 nmol/L) than non-diabetic group (35.17±8nmol/L). There were significant inverse associations between SHBG, Age, disease duration, body mass index, fasting blood sugar, postprandial glucose. On the other hand there were no significant correlations between SHBG and waist circumference, fasting insulin, HOMA-IR, cholesterol and triglyceride levels. Conclusion: low SHBG is associated with hyperglycemia in both males and females, independently of insulinemia. Key Words: sex hormone binding globulin, Insulin resistance, type 2 diabetes mellitus, Obesity.
Effect of obesity and body fat distribution on sex hormones and insulin in men
Metabolism, 1991
To investigate the relationship between body fat distribution, sex hormones, and hyperinsulinemia in male obesity, we examined 52 obese men (body mass index [BMI], 35.0 + 6.1, mean + SD) and 20 normal-weight controls. Their waist to hip circumference ratio (WHR), which was used as an index of fat distribution, was 0.985 f 0.052 and 0.913 rfr 0.061 (P < .005), respectively. Compared with controls, obese men presented significantly lower levels of total (357 + 132 v 498 t-142 ng/dL; P < .005) and free testosterone (14.2 k 2.9 v 17.1 f 2.6 pg/mL; P < .05) and sex hormone-binding globulin (SHBG; 41.7 r 31.9 v 66.2 5 18.6 nmol/L; P < .OOl) without any significant difference on the other sex steroid or on gonadotropin concentrations. Fasting and glucose-stimulated insulin and C-peptide levels were significantly higher in obese than in controls, and in obese with the WHR value greater than 0.87 (corresponding to the distribution median) than in those with WHR lower or equal to 0.97. BMI was negatively correlated with testosterone (P < .005), free testosterone (P < .Ol), and SHBG (P < .OOl) and positively with fasting (P < ,001) and glucose-stimulated (P < .005) C-peptide concentrations, whereas no relationship was found between these variables and WHR values. On the contrary, WHR wassignificantly correlated with fasting and post-glucose insulin levels (P < .05), but not with those of sex steroids. The correlation coefficients did not change significantly after correction for BMI, age, and WHR values. Moreover, we found a significant negative correlation between insulin concentrations and SHBG or testosterone levels, regardless of the effect of BMI, WHR, and age. These results, therefore, suggest that in obese men, at variance with what was observed in obese women, sex steroid abnormalities mainly depend on the degree of obesity, whereas the degree of hyperinsulinemia seems to be more correlated with the type of body fat distribution. Moreover, they suggest the possibility that hyperinsulinemia may be involved in the regulation of sex hormone metabolism in obese men, by mechanisms that urobablv differ from those involved in the development of hyperandrogenism in obese women.
Journal of Endocrinological Investigation, 2008
SHBG is a major carrier of androgens. In men, SHBG levels increase with age, while in women data are scant. There is evidence that body mass index (BMI) and fasting insulin influence SHBG concentration. Since low SHBG levels are predictors of insulin resistance and diabetes, understanding the relationship of SHBG with age, insulin, and BMI is important to gain insight into the role of SHBG as a cardiovascular risk factor in women. Differences in SHBG across adult life span and their relationship with insulin and BMI were evaluated in a representative cohort of 616 Italian women free of diabetes and not on hormone replacement therapy enrolled in the InCHIANTI Study. The relationship of SHBG with age, BMI, and fasting insulin levels was analyzed using linear regression and by loess smoother. Serum SHBG levels showed a U-shaped trajectory with age, declining from the 2 nd to the 6 th decade of life and increasing after the 6 th decade (p<0.0001). Age-related trends for BMI and fasting insulin mirrored the trend observed for SHBG. After adjusting for fasting insulin, the relationship between log (SHBG) and age square was attenuated (β coefficient from 0.00044 to 0.00039) and was further reduced after adjustment for BMI (from 0.00039 to 0.00028). SHBG levels show an age-related U-shaped trajectory. These changes mirror the age-related changes in BMI and fasting insulin, suggesting that BMI and insulin negatively influence SHBG concentration.
Alexandria Journal of Medicine, 2014
Background: Angiopoietin related growth factor (AGF) is a liver derived factor that potently antagonizes obesity and insulin resistance (IR). Aim: The objective of this work is to determine AGF serum levels and evaluate its relationship with total testosterone (TT), calculated free testosterone (cFT), sex hormone binding globulin (SHBG), insulin and IR in normal weight and obese men. Subjects: A total of 60 men were included: twenty normal weight subjects with body mass index (18.5-24.7 kg/m 2 ) and 40 obese men with BMI (30-39.5 kg/m 2 ). Methods: Serum AGF was measured by enzyme linked immunosorbent assay. Serum TT, SHBG, and insulin were analyzed by chemiluminescent immunoassay. Results: Angiopoietin related growth factor was significantly lower in the obese group as compared with normal weight group. In all subjects, AGF correlated positively with TT and SHBG and negatively with 2 h oral glucose tolerance test (OGTT) glucose and fatty liver index (FLI). In normal weight group, AGF correlated positively with age, SHBG, fasting insulin, HOMA-IR, AST and Abbreviations: AGF, angiopoietin related growth factor; FLI, fatty liver index; MAPK, mitogen activated protein kinase; PPARs, peroxisome proliferator activated receptors; PGC-1a, peroxisome proliferator activated receptor ! coactivator 1a.
Journal of Clinical Endocrinology & Metabolism, 1994
It is known that there is an inverse relationship between the serum levels of insulin and sex hormone-binding globulin (SHBG) in women, but the relationship in men has not been reported. It is not known whether changes in the one cause changes in the other, or whether they change in opposite directions in response to some third factor. Because obesity raises insulin levels and lowers SHBG levels in both sexes, we proposed to study the cause-effect question by determining whether the relationship between changes in SHBG and insulin levels during active weight loss. We studied 70 healthy weight-stable men with body mass index (BMI) from 20.7-94 (normal, 22.5 + 2.5) and restudied 17 of them during diet-induced weight loss. Fasting serum insulin levels in the weight-stable men showed a positive linear correlation with BMI, increasing 1 pU/mL per unit increase in BMI (P < 0.0001). SHBG levels in the weight-stable men showed a negative linear correlation with BMI, decreasing 0.2 nmol/L per unit increase in BMI (P < 0.0002). In the weight-stable men, there was an inverse hyperbolic correlation between SHBG and insulin levels; SHBG (nmol/L) = 13.1
Effect of insulin sensitivity on SHBG levels in premenopausal versus postmenopausal obese women
Advances in Therapy, 2007
This study was performed to evaluate the impact of insulin sensitivity on sex hormone-binding globulin (SHBG) and sex steroids in premenopausal and postmenopausal euthyroid obese women. A total of 227 women were eligible for this study. All were euthyroid, obese, and overweight; ages ranged from 25 to 69 years. Women were divided into premenopausal (n=151) and postmenopausal (n=76) groups. SHBG, sex steroids, thyrotropin, fasting and postprandial glucose, lipid profile, uric acid, serum insulin, and blood pressure were measured. No significant difference was found in mean SHBG levels between premenopausal and postmenopausal women. The investigators observed that during transition from premenopause to postmenopause, SHBG levels increased in insulin-sensitive women in the postmenopausal group; however, SHBG levels decreased in insulinresistant women. It was concluded that SHBG blood concentration factors are likely to change during transition from premenopause to postmenopause. The positive effect of estradiol on SHBG levels is probably stronger in premenopausal women than in postmenopausal women. It has been noted that after menopause, the impact of insulin resistance on SHBG level seems more important than the effect of estradiol.
Indian Journal of Medical Sciences, 2008
BACKGROUND AND AIMS: The aim of this study was to determine sex hormone binding globulin (SHBG) concentrations in premenopausal obese women and to evaluate the relationships between sex hormones and features of the metabolic syndrome (MetS). Settings and Design: Retrospective cross-sectional analysis was carried out on 350 obese patients aged 25 to 69 years referred to the Department of Endocrinology, Pamukkale University in 2002-2003. MATERIALS AND METHODS: 125 premenopausal euthyroid patients were eligible for this study. Subjects were divided into two groups according to the body mass index (BMI): Group I, women with BMI < 30 kg/m 2 (n = 17) and Group II,, women with BMI ≥ 30 kg/m 2 (n = 108). Median SHBG concentration of Group I was 50.1 nmol/L. Group II was divided into two subgroups according to the median SHBG concentration of Group I: subjects with high SHBG levels (SHBG concentration ≥ median level of the control group, i.e ≥ 50.1 nmol/L) and subjects with low SHBG levels (< 50.1 nmol/L). All statistical analyses were performed using SPSS 9.0 software (SPSS Inc.). RESULTS: No significant difference was found in mean age between the low and high SHBG groups. The low SHBG group was significantly heavier, and with higher waist circumference than the high SHBG group. In the low SHBG group, fasting glucose, postprandial glucose and gamma glutamyl transferase (GGT) and free androgen index (FAI) were significantly higher. Lipid profile, blood pressure, uric acid, insulin and HOMA were found similar between two groups. Linear regression analyses revealed that body mass index and FAI were significant, being independent predictors of SHBG concentrations in premenopausal women. (r = 0.365, r square = 0.134). CONCLUSIONS: It is concluded that low SHBG concentrations may indicate visceral obesity and glucose intolerance in premenopausal women.
Diabetes Care, 2009
OBJECTIVE-Early puberty is associated with increased risk of subsequent cardiovascular disease. Low sex hormone-binding globulin (SHBG) levels are a feature of early puberty and of conditions associated with increased cardiovascular risk. The aim of the present study was to evaluate SHBG as a predictor of glucose metabolism and metabolic risk during puberty. RESEARCH DESIGN AND METHODS-This was a cross-sectional study on 132 healthy Caucasian children and adolescents evaluated by an oral glucose tolerance test, a dualenergy X-ray absorptiometry scan, direct oxygen uptake measurement during cycle ergometry, and fasting blood samples. RESULTS-SHBG levels declined with advancement of puberty in both boys (P Ͻ 0.001) and girls (P ϭ 0.019). SHBG was significantly positively associated with insulin sensitivity in boys (P Ͻ 0.001) and girls (P Ͻ 0.001). In addition, SHBG was a strong predictor of insulin sensitivity (P ϭ 0.001) and the only predictor of the disposition index (P ϭ 0.031) after adjustment for puberty, fat mass, and aerobic fitness. SHBG was significantly negatively associated with metabolic risk (P ϭ 0.032) and with hypersensitive C-reactive protein levels (P ϭ 0.030) after adjustment for relevant confounders. CONCLUSIONS-SHBG was a strong predictor of insulin sensitivity and metabolic risk during puberty. Thus, we hypothesize that SHBG integrates the marked changes in glucose metabolism and body composition that occur during the pubertal transition.