Racial disparities in metabolism, central obesity, and sex hormone-binding globulin in postmenopausal women
Racial disparities in metabolism, central obesity, and sex hormone-binding globulin in postmenopausal women
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DOI：
10.1210/jc.86.1.97
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发表时间：
2001-01-01
影响因子：
5.8
通讯作者：
Goldberg, AP
中科院分区：
文献类型：
--
作者：
Berman, DM;Rodrigues, LM;Goldberg, AP
在年轻和老年高加索人（CAU）和年轻非洲裔美国人（AA）女性中，总脂肪和腹内脂肪（LAF）肥胖以及与胰岛素抵抗综合征（IRS）相关的其他代谢疾病与低水平的性激素结合球蛋白（SKBG）有关。我们研究了绝经后AA妇女，一个肥胖和IRS发生率高的人群，尽管IAF低，与CAU妇女相比，是否会有更高的循环SHBG水平，以及肥胖指数与IRS和SHBG水平相关的危险因素之间是否存在负相关关系。我们测量了55名CAU（平均+/-SD，59 +/-7岁）和35名AA（57 +/-6岁）久坐不动的肥胖妇女（48%体脂，通过双能X线吸收法）的身体组成，SHBG，游离睾酮，瘦素，葡萄糖耐量，胰岛素和脂蛋白脂质。与CAU妇女相比，AA妇女腰围较大（101与96 cm），脂肪量较大（44.9 +/-8.8 vs. 39.9 +/-8.1 kg），皮下脂肪面积较大（552 +/-109 vs. 452 +/-109 cm（2）），IAF/SC比值较低（0.28 +/-0.12 vs. 0.38 +/-0.15; P <0.01），但腰臀比相似（0.83）。两组的SHBG（117对124 nmol/L）和游离睾酮（3.7对3.4 pmol/L）水平相似，但AA女性的瘦素水平高35%，空腹胰岛素水平高34%，胰岛素对葡萄糖负荷的反应高39%（P <0.05）。在CAU中，女性SHBG与体重指数呈负相关，而在AA中则不然（r =-0.28; P <0.05），腰（r =-0.36; P = 0.01），IAF（r =-0.34，P = 0.01），胰岛素对口服葡萄糖的反应与高密度脂蛋白胆固醇呈正相关（r = 0.30; P = 0.03）。调整IAF后，CAU女性胰岛素面积与SHBG之间的关系消失，而调整IAF后，高密度脂蛋白胆固醇与SHBG之间的关系仍然存在，但不包括脂肪量。两组女性瘦素水平均与脂肪量呈正相关（P <0.05），但仅白人女性瘦素水平与胰岛素水平呈正相关（P <0.01）。瘦素与脂肪量关系的斜率存在种族差异（P <0.05）。调整空腹胰岛素后，瘦素的种族差异消失。这些结果表明，总的和区域的肥胖，葡萄糖和脂代谢与性激素结合球蛋白的CAU妇女的代谢关系是不同的绝经后肥胖AA妇女。
Increased total and intraabdominal fat (LAF) obesity as well as other metabolic conditions associated with the insulin resistance syndrome (IRS) are related to low levels of sex hormone-binding globulin (SKBG) in young and older Caucasian (CAU) and young African-American (AA) women. We examined whether postmenopausal AA women, a population with a high incidence of obesity and IRS despite low IAF, would have higher levels of circulating SHBG compared with CAU women, and whether there would be negative relationships between indexes of obesity and risk factors associated with IRS and SHBG levels. We measured body composition, SHBG, free testosterone, leptin, glucose tolerance, insulin, and lipoprotein lipids in 55 CAU (mean +/- SD, 59 +/- 7 yr) and 35 AA (57 +/- 6 yr) sedentary women of comparable obesity (48% body fat, by dual energy x-ray absorptiometry). Compared with CAU women, AA women had larger waist (101 vs. 96 cm), larger fat mass (44.9 +/- 8.8 vs. 39.9 +/- 8.1 kg), larger sc fat area (552 +/- 109 vs. 452 +/- 109 cm(2)), and lower IAF/SC ratio (0.28 +/- 0.12 vs. 0.38 +/- 0.15; P < 0.01), but similar waist to hip ratio (0.83). Both groups had similar SHBG (117 vs. 124 nmol/L) and free testosterone (3.7 vs. 3.4 pmol/L) levels, but AA women had a 35% higher leptin, 34% higher fasting insulin, and 39% greater insulin response to a glucose load (P < 0.05) compared with CAU women. In CAU, but not AA, women SHBG correlated negatively with body mass index (r = -0.28; P < 0.05), waist (r = -0.36; P = 0.01), IAF (r = -0.34; P = 0.01), and insulin response to oral glucose (r = -0.37; P < 0.05) and positively with high density lipoprotein cholesterol (r = 0.30; P = 0.03). The relationship between insulin area and SHBG in CAU women disappeared after adjusting for IAF, whereas the relationship between high density lipoprotein cholesterol and SHBG persisted after adjusting for IAF, but not for fat mass. Leptin was positively related to fat mass (P < 0.05) in both groups, but it was related to insulin only in the Caucasian women (P < 0.01). There was a racial difference in the slopes (P < 0.05) of the relationships of leptin to fat mass (P < 0.05). Racial differences in leptin disappeared after adjustment for fasting insulin. These results suggest that the metabolic relationships between total and regional obesity, glucose, and lipid metabolism with SHBG in CAU women are different from those in postmenopausal obese AA women.