不同糖耐量成年男性性激素结合球蛋白与脂代谢、腹腔内脏脂肪面积相关性的研究

Serum SHBG level in male adults with different glucose tolerance and its correlation with lipid metabolism and visceral fat area

目的探讨不同糖耐量成年男性性激素结合球蛋白(SHBG)与脂代谢、腹腔内脏脂肪面积(VFA)的相关性。方法选取2018年1月至2020年12月于九〇三医院内分泌科门诊及住院治疗的男性新诊断T2DM患者以及我院体检健康者,根据OGTT结果分为正常糖耐量组(NGT,n=179)、IGR组(n=90)和新诊断T2DM组(T2DM,n=204)。比较各组生化指标、性激素结合球蛋白(SHBG)、VFA等。结果与NGT组比较,IGR组WC、WHR、BMI、HbA1c、FPG、2 hPG、2 h Ins、TG、VFA升高,SHBG降低(P<0.05);T2DM组WC、SBP、DBP、HbA1c、FPG、2 hPG、2 h Ins、胰岛素抵抗指数(HOMA-IR)、TG、FFA、VFA、VFA/SFA升高,胰岛β细胞功能指数、SHBG降低(P<0.05);与IGR组比较,T2DM组SBP、HbA1c、FPG、2 h PG、2 hIns、HOMA-IR升高,HOMA-β降低(P<0.05)。Pearson相关分析显示,SHBG与HDL-C呈正相关(P<0.01),与WC、WHR、BMI、2 hIns、SUA、TG、VFA、SFA呈负相关(P<0.05或P<0.01)。多元线性回归分析显示,VFA、HDL-C、TG是SHBG的影响因素。结论血清SHBG与腹型肥胖、脂代谢密切相关,提高SHBG可减少内脏脂肪堆积并改善IR。

Objective To investigate the correlation between sex hormone-binding globulin(SHBG)and lipid metabolism and visceral fat area(VFA)in male adults with different glucose tolerance.Methods A total of 473 male subjects were enrolled from the outpatient clinic and ward in PLA NO.903 Hospital from January 2018 to December 2020.All the subjects were divided into three groups according to OGTT results:normal glucose tolerance group(NGT,n=179),impaired glucose regulation group(IGR,n=90)and newly diagnosed type 2 diabetes mellitus group(T2DM,n=204).Serum SHBG level,abdominal visceral fat area(VFA)and biochemical indexes were compared among the three groups.RHesultsCompared with NGT group,WC,WHR,BMI,HbAic,FPG,2 hPG,2 hIns,TG and VFA were increased(P<0.05),while SHBG was decreased(P<0.05)in IGR group.WC,SBP,DBP,HbAic,FPG,2 hPG,2 hIns,HOMA-IR,TG,FFA,VFA and VFA/SFA were increased,while HOMA-β,SHBG were decreased(P<0.05)in T2DM group.Compared with IGR group,SBP,HbAic,FPG,2 hPG,2 hIns and HOMA-IR were increased,HOMA-βwas decreased in T2DM group(P<0.05).Pearson correlation analysis showed that SHBG was positively correlated with HDL-C(P<O.O1),but was negatively correlated with WC,WHR,BMI,2 hIns,SUA,TG,VFA and SFA(P<0.05 or P<0.01).Multivariable linear regression analysis showed that HDL-C,TG and VFA were the influencing factors for SHBG.Conclusio1nSerum SHBG is closely related to abdominal obesity and lipid metabolism.Increasing the level of SHBG can reduce visceral fat accumulation and improve IR.