摘要
探讨在老年男性中性激素结合球蛋白（SHBG） 与代谢综合征的相关性。选择参加体检的老年男性354例。测量身高、体重、腰围、臀围，检测测量空腹血糖、空腹胰岛素、血脂、总睾酮、SHBG。根据2004年中华医学会糖尿病学分会关于代谢综合征的建议诊断代谢综合征。代谢综合征组与非代谢综合征组间的血清SHBG有明显差异［（40.50 ± 26.16）nmol/L对（47.80 ± 20.34）nmol/L, P〈0.01］。随着代谢综合征组分数的增加，SHBG水平降低。根据SHBG水平的四分位数分组，各组间随着SHBG水平的增高，体重指数、腰臀比、舒张压、空腹血糖、甘油三酯、空腹胰岛素、稳态模型评估的胰岛素抵抗指数（HOMA-IR）、游离睾酮、游离睾酮指数、游离睾酮百分数降低，而年龄和高密度脂蛋白胆固醇增高。SHBG与代谢综合征除血压外各组分具有显著的相关性。Logistic回归分析，HOMA-IR、SHBG进入回归方程。老年男性中代谢综合征患者SHBG水平降低，SHBG与代谢综合征各组分相关，低SHBG可能是代谢综合征的独立危险因素。
To investigate the relationship between sex hormone binding globulin（SHBG） and metabolic syndrome in elderly males in Shanghai, all the subjects（≥60 years old, male） underwent measurements of weight, height, waist and hip circumferences, and blood pressures, serum levels of fasting plasma glucose, total cholesterol, triglyceride, high density lipoprotein-cholesterol（HDL-C）, and low density lipoprotein-cholesterol were determined（Hitachi,7600）, while the levels of serum insulin, total testosterone, and SHBG were determined by using chemiluminescence methods. Free testosterone was calculated by using the Vermeulen equation. Metabolic syndrome was defined according to the criteria of the Chinese Diabetes Society（CDS 2004）. The SHBG level in the metabolic syndrome group was significantly lower than that in non-metabolic syndrome group [（40.50 ± 26.16）nmol/L vs （47.80 ± 20.34）nmol/L,P〈0.01]. With increasing number of metabolic syndrome components, the level of SHBG became lowered progressively. The subjects were divided into four subgroups according to SHBG Quartiles. From Quartile 1 to Quartile 4, body mass index, waist-hip ratio, diastolic blood pressure, fasting plasma glucose, triglyceride, fasting insulin, homeostasis model assessment for insulin resistance（HOMA-IR）, free testosterone, free androgen index, and free testosterone percentage became progressively lowered, while age and HDL-C became raised（P〈0.05）. SHBG was correlated significantly with age, body mass index, waist-hip ratio, diastolic blood pressure, fasting plasma glucose, HDL-C, and triglyceride. Age, HDL-C, and body mass index remained independently associated with SHBG in the multivariate regression analysis. In a logistic regression taking metabolic syndrome as the dependent variable, SHBG and HOMA-IR were included in the final model with statistical significance. Lowered SHBG is a risk factor of metabolic syndrome in elderly males. SHBG may be an independent predictor of metabolic syndrome, but the mechanism of how SHBG is involved in the metabolic syndrome needs to be further studied.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2013年第4期318-321,共4页
Chinese Journal of Endocrinology and Metabolism
