血清性激素结合球蛋白水平对2型糖尿病患者合并代谢综合征的影响研究

Influence of Serum Sex Hormone- binding Globulin Level on Type 2 Diabetes Complicated With Metabolic Syndrome

目的探讨血清性激素结合球蛋白(sex hormone-binding globulin,SHBG)水平对2型糖尿病患者合并代谢综合征的影响。方法选取2012年6月—2014年11月到中国医科大学附属第一医院就诊的2型糖尿病患者307例。根据代谢综合征的诊断标准,将纳入患者分为单纯2型糖尿病组(G_0组,n=82)、2型糖尿病合并1项代谢综合征诊断标准组(G_1组,n=46)、2型糖尿病合并2项代谢综合征诊断标准组(G_2组,n=61)、2型糖尿病合并3项代谢综合征诊断标准组(G_3组,n=71)、2型糖尿病合并4项代谢综合征诊断标准组(G_4组,n=47)。收集各组患者的临床资料,探讨血清SHBG水平对2型糖尿病患者合并代谢综合征的影响。结果 5组患者性别、年龄、病程、空腹血糖(FPG)及糖化血红蛋白(Hb A1c)比较,差异无统计学意义(P>0.05);5组患者BMI、腰围、收缩压、舒张压、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、血尿酸(UA)、空腹胰岛素及胰岛素抵抗指数(HOMA-IR)比较,差异有统计学意义(P<0.05);5组男性患者血清SHBG水平比较,差异有统计学意义(P<0.05);5组女性患者血清SHBG水平比较,差异有统计学意义(P<0.05);各组不同性别患者血清SHBG水平比较,差异无统计学意义(P>0.05)。Pearson相关分析显示,血清SHBG水平与BMI、腰围、FPG、TG、UA、空腹胰岛素、HOMA-IR呈线性负相关(P<0.05);与HDL-C呈线性正相关(P<0.05)。有序多分类Logistic回归分析显示,血清SHBG水平对2型糖尿病患者合并代谢综合征的影响有统计学意义(P<0.05)。结论血清SHBG水平是2型糖尿病患者合并代谢综合征的影响因素,较低血清SHBG水平患者的患病风险较大。

Objective To investigate the influence of sex hormone-binding globulin（ SHBG） on type 2 diabetes mellitus（ T2DM） combined with metabolic syndrome（ MS）. Methods From June 2012 to November 2014,we enrolled 307T2 DM patients who received treatment in the First Hospital Affiliated to China Medical University. Based on the diagnostic criteria of MS,the patients were divided into pure T2 DM group（ G0 group,n = 82） and group of T2 DM plus one item of MS（ G1 group,n = 46）,group of T2 DM plus 2 items of MS（ G2 group,n = 61）,group of T2 DM plus three items of MS（ G3 group,n= 71） and group of T2 DM plus 4 items of MS（ G4 group,n = 47）. Clinical data of the five groups were collected,and the influence of SHBG level on T2 DM combined with MS was investigated. Results The five groups were not significantly different in gender,age,length of disease, FPG and Hb A1c（ P 〉0. 05）,but were significantly different in BMI,waistline,systolic pressure,diastolic pressure,TG,HDL-C,UA,fasting insulin and HOMA-IR（ P 〈0. 05）. The five groups were significantly different in the SHBG level of males（ P 〈0. 05）,and were also significantly different in that of females（ P 〈0. 05）. There was no significant differences in SHBG level between male and female patients in each group（ P 〉0. 05）. Pearson correlation analysis showed that SHBG level had negative correlation with BMI,waistline,FPG,TG,UA,fasting insulin,and HOMA-IR（ P 〈0. 05） and had positive correlation with HDL-C（ P 〈0. 05）. Ordinal multi-classification Logistic regression analysis showed that SHBG level had significant influence on T2 DM combined with MS（ P 〈0. 05）. Conclusion SHBG level is an influencing factor for T2 DM combined with MS,and lower SHBG level is associated with the higher risk.