2型糖尿病患者绝经后血清性激素结合球蛋白与下肢血管病变的相关性

The association between serum sex hormone-binding globulin and lower limb vascular disease in postmenopausal women with type 2 diabetes

目的探讨血清性激素结合球蛋白水平（SHBG）与绝经后2型糖尿病（T2DM）患者下肢血管病变的相关性。方法选取150例绝经后T2DM患者,根据双下肢高分辨彩色多普勒检查分为单纯T2DM（A组）50例,合并轻度下肢动脉粥样硬化（B组）45例,合并重度下肢动脉粥样硬化（C组）55例;并选取同期来本院体检的45例绝经后健康者为对照（NC）组,对各组患者进行临床资料收集及常规生化指标检测,采用电化学发光法检测各组空腹血清SHBG及睾酮（T）、雌二醇（E2）,促卵泡刺激素（FSH）,黄体生成素（LH）水平,并分析SHBG与其他指标的关系。结果4组血清SHBG水平依次为：NC组[（60.4±8.8）μg/L]〉A组[（44.1±6.1）μg/L]〉B组[（33.6±4.9）μg/L]〉C组[（25.83±3.4）μg/L];T2DM组中,血清SHBG水平与HbA1c、TG、T、LDL-C、HOMA-IR负相关（r值分别为-0.605、-0.164、-0.351、-0.247、-0.649,P〈0.05）;回归分析结果显示,校正混杂因素后,血清SHBG水平仍与糖尿病下肢血管病变相关（OR=1.674,P=0.001,95%CI：1.124~2.146）。结论低水平的SHBG是绝经后2型糖尿病患者下肢血管病变的危险因素之一。

Objective To explore the relationship between serum level of sex hormone-binding globulin（SHBG）and lower limb vascular disease（LLVD）in postmenopausal women with type 2diabetes（T2DM）.Methods Bilateral lower limb vessels were checked by the High Resolution Color Doppler in 150T2 DM patients as well as 45 healthy subjects as control（NC group）.And the T2 DM patients were divided into 50T2 DM patients without LLVD（group A）,45 patients with mild LLVD（group B）,and 55 patients with severe LLVD（group C）.Clinical date were collected,routine biochemical indices were determined,and serum sex hormone-binding globulin,testosterone（T）,estradiol（E2）,follicle-stimulating hormone（FSH）and luteinzing hormone（LH）were measured in patients with T2 DM and healthy subjects by Electrochemiluminescence.Results The serum level of SHBG in four groups were in order as following：NC group[（60.4±8.8）μg/L],group A [（44.1±6.1）μg/L],group B[（33.6±4.9）μg/L]and group C [（25.83±3.4）μg/L].In T2 DM group,the serum SHBG level was negatively correlated with HbA1 c,TG,LDL-C and HOMA-IR（r=-0.605,-0.164,-0.247and-0.649,P〈0.05）.Logistic regression analysis showed that serum SHBG level was independently related to LLVD after removing the confounding factors（OR=1.674,P=0.001,95%CI：1.124-2.146）.Conclusion Lower SHBG is a risk factor for LLVD in postmenopausal women with T2 DM.