低浓度性激素结合球蛋白与代谢综合征的发生相关

Low level of serum sex hormone binding globulin is associated with the occurrence of metabolic syndrome

目的在中国青年人群中，探讨性激素结合球蛋白（SHBG）与代谢综合征（MS）发生之间的相关性。方法共纳入797例受试者，按照ATPm标准，将研究人群划分为MS组和非MS组。采用化学发光分析法检测SHBG水平，同时检测空腹血糖（FPG）、空腹胰岛素、肝。肾功能及血脂各项指标，计算体重指数和腰臀比，并以稳态模型计算胰岛素抵抗指数（HOMA—IR）。结果非MS组的血清SHBG水平显著高于MS组[（34．97±33．97对19．54±15．54）nmol／L，P〈0．001]。在总人群中，校正年龄，性别，体重指数及腰臀比之后，SHBG与舒张压、空腹血糖、空腹胰岛素、HOMA—IR、甘油三酯呈负相关（均P〈0．05），SHBG与高密度脂蛋白胆固醇（HDL—C）呈显著正相关（P〈O．001）。Logistic回归分析发现，校正年龄，性别，体重指数．腰臀比及HOMA—IR之后．SHBG与MS的发生风险呈显著负相关（OR=0．978，95％C10．967～0．989，P〈0．001）；进一步将受试者按照SHBGi分位进行分组，从低到高分为3组：Ter1，Ter2和Ter3。Ter1组发生MS的风险是Ter3组的2．960倍（95％CIi．812～4．835，P〈0．001）。结论在中国青年人群中，较低浓度的血清SHBG与MS的发生相关。

Objective To investigate the relationship between serum sex hormone binding globulin （SHBG） and metabolic syndrome （ MS ） in Chinese young population. Methods A total of 797 patients were enrolled and subdivided into MS group （n = 377 ）and non-MS group （n = 420）. Body height and weight were measured for body mass index（ BMI ） , and waist and hip circumstances for waist-to-hip ratio （WHR）. Glutamate aminotransferase, aspartatc aminotransfcrase, serum lipid level, fasting glucose and fasting insulin were determined. The level of serum SHBG was measured by chemiluminescent microparticle immunoassay. HOMA-IR was employed to evaluate the insulin sensitivity. Results The serum SHBG level of non-MS group was significantly higher than that in MS group [ （ 34.97 ± 33.97 vs 19.54± 15.54） nmol/L, P〈0.0011- After adjusted for age, sex, BMI, and WHR, serum SHBG level was negatively associated with diastolic blood pressure, fasting plasma glucose, fasting insulin, homeostasis model assessment for insulin resistance （ HOMA-IR ） , and triglyeerides （ P 〈 0. 05 ） , but it was significantly positively associated with HDL-C （P〈0. 001 ）. After adjusted for age, sex, BMI, WHR, and HOMA-IR, binary, logistic regression analysis showed that serum SHBG level was negatively associated with metabolic syndrome. Conclusions In Chinese young population, low level of serum SHBG is associated with the occurrence of metabolic symlrome.