Graves病患者性激素与性激素结合球蛋白水平的相关性研究

Association of sex hormone and sex hormone-binding globulin levels in patients with Graves′ disease

目的探讨Graves病患者性激素与性激素结合球蛋白(SHBG)水平的关系。方法回顾性分析2017年12月至2019年7月于复旦大学附属中山医院住院的Graves病患者152例,测量身高、体重,检测甲状腺功能、性激素、空腹血糖、胰岛素、C肽、糖化白蛋白、HbA1C、肝功能等指标。分析SHBG水平与临床及生化指标的相关性。结果Graves病患者糖化白蛋白与SHBG呈负相关(β=-0.308,P<0.01),但校正了甲状腺激素后糖化白蛋白与SHBG无相关性。男性患者SHBG水平显著低于女性患者(P<0.01)。男性患者SHBG水平与促黄体生成素(r=0.465,P<0.01)、雌二醇(r=0.629,P<0.01)、睾酮(r=0.786,P<0.01)呈正相关。女性患者SHBG水平也与睾酮(r=0.191,P<0.05)呈正相关。多元线性回归显示,男性患者SHBG水平与雌二醇(β=0.329,P<0.01)独立正相关。结论SHBG与Graves病的关系可部分解释甲状腺功能亢进患者性功能障碍及不孕不育的原因。

Objective To identify the association of sex hormone and sex hormone-binding globulin(SHBG)levels in patients with Graves′disease.Methods Between December 2017 and July 2019,152 patients with Graves′disease were enrolled in the Department of Endocrinology and Metabolism of Zhongshan Hospital,Fudan University.Parameters such as height,weight,thyroid function,sex hormone,fasting blood glucose,insulin,C-peptide,glycosylated albumin,HbA1C,and liver function were collected.The associations between SHBG and bioclinical characteristics were analyzed.Results The glycosylated albumin level was negatively associated with SHBG in all subjects(β=-0.308,P<0.01),while this association was not significant after the adjustment for thyroid hormones.Male patients had significantly lower SHBG level than female patients(P<0.01).In male patients,SHBG was associated with luteinizing hormone(r=0.465,P<0.01),estradiol(r=0.629,P<0.01),testosterone(r=0.786,P<0.01).While in female patients,SHBG was also associated with testosterone(r=0.191,P<0.05).In multivariate linear regression analysis,estradiol was independently associated with SHBG(β=0.329,P<0.01)in male subjects.Conclusion The hypogonadism and infertility in Graves′disease patients could partially be attributed to the association between SHBG and Graves′disease.