男性代谢综合征患者性激素结合球蛋白水平的变化

Changes of sex hormone binding globulin level in male patients with metabolic syndrome

目的观察男性代谢综合征(MS)患者性激素结合球蛋白(SHBG)水平的变化。方法186例住院男性患者分为MS组112例和非MS组74例;比较两组患者血压、血糖、血脂、胰岛功能以及SHBG水平。按SHBG水平,患者分为低SHBG组(20.36nmol/L>SHBG≥2.32nmol/L,62例)、中SHBG组(32.54nmol/L>SHBG≥20.36nmol/L,62例)和高SHBG组(85.42nmol/L≥SHBG≥32.54nmol/L,62例)。分层分析SHBG水平与相关指标的相关性,探讨MS发生的相关影响因素。结果与非MS组比较,MS组FBG、HbA1c、TG、TC、尿酸、FIns水平和HOMA-IR均升高,而HDL-C和SHBG水平降低(P<0.05)。与高SHBG组相比,低SHBG组MS及其组分糖尿病、超重或肥胖、高TG血症、低HDL-C血症患者比例均增高(P<0.05),但高血压患者比例无统计学差异(P>0.05)。Pearson线性相关分析显示,SHBG与BMI、TG呈负相关(r=-0.080、-0.096,P<0.05),与HDL-C呈正相关(r=0.223,P<0.05)。Logistic回归分析显示,SHBG降低为MS的独立危险因素[OR=1.246,95%CI(1.015~1.131),P<0.05]。结论男性MS患者SHBG水平降低。SHBG降低为MS的独立危险因素。

Objective To observe the changes of sex hormone binding globulin（SHBG）in male patients with metabolic syndrome（MS）.Methods A total of 186 male hospitalized patients was divided into two groups of A（with MS,112 cases）and B（without MS,74 cases）.Blood pressure,blood glucose,blood lipids,islet function and SHBG levels were compared between two groups.According to SHBG levels,the patients were assigned into three groups of L（with low SHBG level,20.36 nmol/L〉SHBG≥2.32 nmol/L,62 cases）,M（with middle SHBG level,32.54 nmol/L〉SHBG≥20.36 nmol/L,62 cases）and H（with high SHBG level,85.42 nmol/L≥SHBG≥32.54 nmol/L,62 cases）.A stratified analysis of SHBG levels with MS components（overweight or obesity,diabetes mellitus,hypertension,hypertriglyceridemia and low HDL-C hyperlipidemia）and various metabolic parameters was performed.The relevant influencing factors for MS were analyzed.Results Compared with group B,the levels of FBG,HbA1 c,TG,TC,uric acid,FIns and HOMA-IR in group A were all increased,while the levels of HDL-C and SHBG were decreased（P〈0.05）.Compared with group H,the proportions of MS and its components of diabetes,overweight or obesity,hypertriglyceridemia in groups of L and M were increased（P〈0.05）,but the proportion of the patients with hypertension was not significantly different among three groups（P〉0.05）.Pearson linear correlation analysis showed that SHBG was negatively correlated with BMI and TG（r=-0.080 and-0.096,P〈0.05）and positively correlated with HDL-C（r=0.223,P〈0.05）.Logistic regression analysis showed that the decrease of SHBG was an independent risk factor for MS[OR=1.246,95%CI（1.015-1.131）,P〈0.05].Conclusion The level of SHBG in male patients with MS is decreased,which is an independent influencing factor for MS.