Sex Hormone-Binding Globulin and Insulin Resistance In Type 2 Diabetes Mellitus
Hatem M. Salem,1 Khaled M. Hadhoud, 1 Mohamed S. S. Saad, 1 and Ahmad Baraka 2
Departments of 1Internal Medicine and 2 Clinical Pathology, Faculty of Medicine, Zagazig University, Egypt.email@example.com
Abstract: Background; Sex hormone-binding globulin (SHBG) regulates the levels of free sex hormones by sequestering circulating sex hormones and participates in some of the biological actions of sex hormones by mediating cellular uptake. Sex hormone binding globulin (SHBG) is the principal transport protein for testosterone and estradiol. Low circulating levels of SHBG are a strong predictor of the risk of type 2 diabetes(T2DM) in women and men. The association between SHBG and incidence of type 2 DM is explained by insulin resistance. Objective: To study the serum level of SHBG and insulin resistance and to determine their risk in T2DM. Subjects and Methods: 80 participants were included in this study were classified into two groups:Control group; Twenty subjects (10 females and 10 males) aged 37.25±9.05 years without history of diabetes mellitus who's fasting blood glucose (FBG) was less than 126 mg/dl on two occasions and were matched for age, sex and body mass index (BMI). Patients group; Sixty patients aged 37.85±12.5 years with T2DM further classified into: Male group; twenty patients aged 38.2 ±13.9 years with T2DM, female group; Forty diabetic females (20 premenopausal and 20 postmenopausal) aged 37.5±10.6 years. Plasma level of SHBG, insulin levels, fasting blood glucose (FBG), 2-h pp glucose (PPBG), HbA1C were measured. Also total cholesterol, HDL-cholesterol, triglyceride, systolic, diastolic BP, BMI were measured and HOMA-IR was calculated. Results:Among women, lower levels of SHBG (8.6±5.1 nmol/l in T2DM and 11.4±4.8 nmol/l in non diabetics) than men (10.1±4.1 nmol/l in T2DM and 13.9±7.2 nmol/l in non diabetics) were associated with increased insulin resistance and hence a higher risk of T2DM. The mean serum level of SHBG was 9.35±5.6 nmol/l in diabetic patients and 12.5±6.9 nmol/l in non-diabetic subjects which was non-significantly different. A significant negative correlation between SHBG and HOMA-IR in males and females T2DM were reported. Conclusion: Lower concentration of SHBG was associated with increased insulin resistance (HOMA-IR) and hence a higher risk of development of T2DM.
[Hatem M. Salem, Khaled M. Hadhoud, Mohamed S. S. Saad, and Ahmad Baraka. Sex Hormone-Binding Globulin and Insulin Resistance In Type 2 Diabetes Mellitus. Life Sci J 2013;10(1):1814-1820]. (ISSN: 1097-8135). http://www.lifesciencesite.com. 261
Key words: Type 2 diabetes mellitus (T2DM), sex hormone-binding globulin (SHBG),Homeostasis model assessment- insulin resistance ( HOMA-IR)