Low Serum Sex Hormone-Binding Globulin Associated with Insulin Resistance in Men with Nonalcoholic Fatty Liver Disease
Low Serum Sex Hormone-Binding Globulin Associated with Insulin Resistance in Men with Nonalcoholic Fatty Liver Disease
复制标题
低血清性激素结合球蛋白与非酒精性脂肪肝患者的胰岛素抵抗相关。
DOI：
10.1055/s-0043-102690
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发表时间：
2017
影响因子：
2.2
通讯作者：
Mo Zengnan
中科院分区：
文献类型：
--
作者：
Ye Juan;Yao Ziting;Tan Aihua;Gao Yong;Chen Yingchun;Lin Xinggu;He Rongquan;Tang Ruiqiang;Hu Yanling;Zhang Haiying;Yang Xiaobo;Wang Qiuyan;Jiang Yonghua;Mo Zengnan
非酒精性脂肪性肝病(NAFLD)的存在是2型糖尿病(T2D)的强烈风险预测因素。性激素结合球蛋白(SHBG)的减少与NAFLD有关。低SHBG也与胰岛素抵抗(IR)有关。然而，对于NAFLD患者中SHBG和IR之间的关联的数据非常有限。本研究旨在阐明非酒精性脂肪肝患者SHBG与胰岛素抵抗之间的关系。在这项横断面研究中，334名患有NAFLD的男性被招募。测定SHBG、总睾酮、游离睾酮、总胆固醇、甘油三酯、胰岛素和葡萄糖浓度。计算稳态模型评估(HOMA)-IR和HOMA-β。采用Spearman相关分析和多元线性回归分析SHBG与IR的关系。中重度NAFLD患者的腰围、体重指数、总胆固醇、甘油三酯、胰岛素、HOMA-IR、HOMA-β和游离睾酮均高于轻度NAFLD患者，但SHBG低于轻度NAFLD患者。中重度非酒精性脂肪肝患者的HOMA-IR(2.38±1.35vs.4.16±2.84，p<；0.001)和SHBG(25.89±11.89vs.30.13±12.97nmoL/L，p<；0.001)均显著高于非酒精性脂肪肝患者(P<0.05)。SHBG值与胰岛素、HOMA-IR呈负相关，与血糖、睾酮无显著相关。多元线性回归分析显示，即使调整了潜在的混杂因素，SHBG与胰岛素(β=− 0.241，p<；0.001)和HOMA-IR(β=− 0.229，p<；0.001)显著相关。结论：低血清SHBG与男性NAFLD患者的胰岛素抵抗有关。
The presence of nonalcoholic fatty liver disease (NAFLD) is a strong risk predictor for type 2 diabetes (T2D). A reduction in sex hormone-binding globulin (SHBG) is associated with NAFLD. Low SHBG is also associated with insulin resistance (IR). However, very limited data are available for the association of SHBG and IR in patients with NAFLD. The study aims to clarify the association between SHBG and IR in patients with NAFLD. In this cross-sectional study, 334 men with NAFLD were recruited. SHBG, total testosterone, free testosterone, total cholesterol, triglyceride, insulin, and glucose concentrations were measured. Homeostatic model assessment (HOMA)-IR and HOMA-β were calculated. Spearman’s correlations and multiple linear regressions were used to analyze the association between SHBG and IR. Men with moderate-severe NAFLD had higher waist circumference, BMI, total cholesterol, triglyceride, insulin, HOMA-IR, HOMA-β, and free testosterone, but lower SHBG than the mild NAFLD. The moderate-severe NAFLD group exhibited higher HOMA-IR (2.38±1.35 vs. 4.16±2.84, p<0.001) and lower SHBG (25.89±11.89 vs. 30.13±12.97 nmol/l, p<0.001) than the other group. SHBG value was negatively correlated with insulin, and HOMA-IR, but was not significantly correlated with glucose and testosterone. The multiple linear regression analysis showed that SHBG was significantly associated with insulin (β=− 0.241, p<0.001), and HOMA-IR (β=− 0.229, p<0.001), even adjusting for potential confounders. In conclusion, low serum SHBG is associated with IR in men with NAFLD.