血清性激素结合球蛋白水平对2型糖尿病合并代谢综合征患者的影响

The level of serum sex hormone binding globulin in patients with type 2 diabetes mellitus complicated with metabolic syndrome influence research

目的分析血清性激素结合球蛋白(SHBG)水平对2型糖尿病合并代谢综合征的影响。方法选取2015年3月—2016年9月湖北省十堰市太和医院内分泌风湿科治疗的2型糖尿病患者220例作为研究对象,根据代谢综合征的诊断标准,将患者分为A组(单纯2型糖尿病组)、B组(2型糖尿病合并1项代谢综合征诊断标准组)、C组(2型糖尿病合并2项代谢综合征诊断标准组)、D组(2型糖尿病合并3项代谢综合征诊断标准组)、E组(2型糖尿病合并4项代谢综合征诊断标准组),每组44例(对比分析5组各项指标情况及其与SHBG相关性。结果 5组患者BMI、收缩压、舒张压、腰围、三酰甘油、高密度脂蛋白胆固醇、血尿酸、空腹胰岛素、胰岛素抵抗指数、男/女血清性激素结合球蛋白水平比较,差异均有统计学意义(F=41.054、73.161、79.994、64.001、151.193、39.742、14.481、58.821、12.223、14.212、6.752,P<0.01);Pearson相关分析显示,血清SHBG水平与BMI、腰围、空腹血糖、三酰甘油、血尿酸、空腹胰岛素、胰岛素抵抗指数呈线性负相关(r=-0.33、-0.32、-0.47、-0.43、-0.49、-0.44、-0.49,P<0.05),与HDL-C呈线性正相关(r=0.34,P<0.05)。结论血清SHBG水平高低对2型糖尿病合并代谢综合征患者的各项指标有一定影响,因而在治疗上应早期检测并予以对症处置,防止疾病进一步恶化。

Objective To investigate the effect of serum sex hormone binding globulin （SHBG） on type 2 diabetes mellitus with metabolic syndrome.Methods Two hundred and twenty cases of type 2 diabetes mellitus treated in endocrine and rheumatoid department were selected as the research object.According to the diagnostic criteria of metabolic syndrome, the patients were divided into two groups.The patients were divided into five groups, group A （type 2 diabetes mellitus group）, group B （type 2 diabetes mellitus with one diagnostic syndrome group）, group C （type 2 diabetes mellitus with 2 metabolic syndrome diagnostic criteria group）, group D （type 2 diabetes mellitus combined with 3 diagnostic criteria for metabolic syndrome）, group E （type 2 diabetes with 4 metabolic syndrome diagnostic criteria group）, 44 patients in each group.Comparative analysis of the five groups of indicators and their relationship with the SHBG were performed.Results There were significant differences in BMI,systolic blood pressure, diastolic blood pressure, waist circumference,triglyceride, high density lipoprotein cholesterol, serum uric acid,fasting insulin,insulin resistance index,male/female serum sex hormone binding globulin.Pearson correlation analysis showed that serum sex hormone levels were correlated with BMI, waist circumference, fasting blood glucose, triglyceride,uric acid,fasting insulin,insulin resistance index（r =-0.33, r =-0.32, r =-0.47, r =-0.43, r =-0.49, r =-0.44, r =-0.49, P 〈0.05）, and there was a linear positive correlation with HDL-C （r =0.34, P 〈0.05）.Conclusion The serum levels of sex hormone binding globulin level in type 2 diabetes with metabolic syndrome patients have certain effect.Therefore, the treatment should be with early detection and symptomatic treatment to prevent further deterioration of the disease.