Is serum sex hormone-binding globulin a dominant risk factor for metabolic syndrome？

This multi-center, cross-sectional study investigated the association between serum testosterone （T） levels, serum sex hormone-binding globulin （SHBG） levels, and the risk of metabolic syndrome （MS） in 3332 adult Chinese men. The prevalence of MS was 34.7%, and men with MS had lower serum levels of total T （TT） and SHBG than those without MS （P 〈 0.001）. There was no significant difference in serum free T （FT） levels between subjects with and without MS （P = 0.627）. In logistic regression analysis, the association between MS and serum SHBG levels persisted after adjusting for age, body mass index （BMI）, smoking and drinking status, and serum TT （odds ratio [OR] 0.962, 95% confidence interval [95% CI] 0.954-0.969, P 〈 0.01）. However, the association between serum TT level and the risk of MS was weak after adjusting for age, BMI, SHBG level, and smoking and drinking status （OR 0,981, 95% CI 0.960-1.007）. Our study reveals that both serum TT and SHBG levels, but not serum FT, are inversely associated with the prevalence of MS and that serum SHBG is an independent and dominant risk factor for MS.This multi-center, cross-sectional study investigated the association between serum testosterone （T） levels, serum sex hormone-binding globulin （SHBG） levels, and the risk of metabolic syndrome （MS） in 3332 adult Chinese men. The prevalence of MS was 34.7%, and men with MS had lower serum levels of total T （TT） and SHBG than those without MS （P 〈 0.001）. There was no significant difference in serum free T （FT） levels between subjects with and without MS （P = 0.627）. In logistic regression analysis, the association between MS and serum SHBG levels persisted after adjusting for age, body mass index （BMI）, smoking and drinking status, and serum TT （odds ratio [OR] 0.962, 95% confidence interval [95% CI] 0.954-0.969, P〈 0.01）. However, the association between serum TT level and the risk of MS was weak after adjusting for age, BMI, SHBG level, and smoking and drinking status （OR 0,981, 95% CI 0.960-1.007）. Our study reveals that both serum TT and SHBG levels, but not serum FT, are inversely associated with the prevalence of MS and that serum SHBG is an independent and dominant risk factor for MS.

Genetic effects on serum testosterone and sex hormone-binding globulin in men： a Korean twin and family study

We conducted a community-based cross-sectional study to evaluate the role of genetics in determining the individual difference in total testosterone and sex hormone-binding globulin levels. Study participants comprised 730 Korean men consisting of 142 pairs of monozygotic twins, 191 pairs of siblings, and 259 father-offspring pairs from 270 families who participated in the Healthy Twin study. Serum concentration of total testosterone and sex hormone-binding globulin were measured by chemiluminescence immunoassay, and free testosterone and bioavailable testosterone were calculated using Vermeulen＇s method. Quantitative genetic analysis based on a variance decomposition model showed that the heritability of total testosterone, free testosterone, bioavailable testosterone, and sex hormone-binding globulin were 0.56, 0.45, 0.44, and 0.69, respectively after accounting for age and body mass index. Proportions of variance explained by age and body mass index varied across different traits, from 8% for total testosterone to 31% for sex hormone-binding globulin. Bivariate analysis showed a high degree of additive genetic correlation （p~ = 0.67） and a moderate degree of individual-specific environmental correlation （PE = 0.42） between total testosterone and sex hormone-binding globulin. The findings confirmed the important role of genetics in determining the individually different levels of testosterone and sex hormone-binding globulin during adulthood in Korean men as found in non-Asian populations, which may suggest that common biologic control for determining testosterone level directly or indirectly through binding protein are largely shared among different populations.

血尿酸及性激素水平与肥胖合并非酒精性脂肪肝儿童的相关性

目的探讨血尿酸及性激素水平与肥胖儿童合并非酒精性脂肪肝(NAFLD)的相关性。方法收集2021年1月至2023年7月在连云港市第一人民医院住院完善糖耐量等检查的124例肥胖儿童的临床资料。回顾性分析两组儿童性别、年龄、身高、体质量、身体质量指数(BMI)、白细胞(WBC)、C反应蛋白(CRP)、空腹血糖(FBG)、空腹胰岛素(FINS)、空腹C肽、胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)、血尿酸(SUA)、肝功能、性激素六项、甲状腺功能[促甲状腺激素(TSH),游离三碘甲状腺原氨酸(FT3),游离甲状腺激素(FT4)]等相关指标。根据空腹超声结果将病儿分为肥胖组和肥胖合并NAFLD两组,对各项指标进行组间比较及相关性分析,采用二元logistic回归模型计算儿童NAFLD危险因素,并绘制受试者操作特征曲线(ROC曲线),以评价不同因素对NAFLD的预测价值。结果入组儿童性别、年龄、身高差异无统计学意义(P>0.05),肥胖合并NAFLD组儿童BMI[(31.59±4.39)kg/m^(2)比(29.53±5.05)kg/m^(2)]、FINS[31.45(23.33,43.06)mIU/L比20.79(15.72,35.72)mIU/L]、HOMA-IR[6.89(4.96,10.29)比4.92(3.26,7.85)]、空腹C肽[1386.50(1088.00,1617.75)pmol/L比1056.00(787.40,1488.25)pmol/L]、WBC[(7.84±1.79)×10^(9)/L比(7.08±1.55)×10^(9)/L]、CRP[2.57(1.21,3.59)mg/L比1.58(0.99,2.64)mg/L]、SUA[(449.35±98.55)μmol/L比(398.64±91.60)μmol/L]、HbA1c[5.40(5.30,5.70)%比5.30(5.10,5.47)%]、三酰甘油(TG)[1.33(0.95,1.92)mmol/L比0.99(0.80,1.51)mmol/L]、谷丙转氨酶(ALT)[38.50(24.50,70.00)U/L比18.00(14.00,28.25)U/L]、谷草转氨酶(AST)[29.00(23.25,44.50)U/L比20.00(17.00,25.75)U/L]、TSH[3.23(2.39,4.58)mIU/L比2.60(2.18,3.78)mIU/L]高于肥胖组,而高密度脂蛋白(HDL)[(1.04±0.20)mmol/L比(1.15±0.25)mmol/L]、性激素结合球蛋白(SHBG)[13.35(10.47,16.60)nmol/L比19.65(13.87,27.20)nmol/L]低于肥胖组,两组比较差异有统计学意义(P<0.05)。相关性分析发现肥胖合并NAFLD儿童SUA水平与HDL(r=−0.26)、SHBG(r=−0.24)呈负相关(P<0.05);肥胖合并NAFLD儿童SHBG水平与BMI(r=−0.35)、FINS(r=−0.39)、HOMRIR(r=−0.36)、空腹C肽(r=−0.45)、CRP(r=−0.22)、SUA(r=−0.24)、TG(r=−0.22)、ALT(r=−0.28)、AST(r=−0.23)呈负相关(P<0.05)。进一步行logistic回归分析,排除混杂因素后发现WBC[OR=1.51,95%CI:(1.10,2.07)]、ALT[OR=1.05,95%CI:(1.01,1.20)]、SHBG[OR=0.92,95%CI:(0.86,0.98)]是肥胖合并NAFLD的危险因素。绘制ROC曲线后发现SHBG单独预测NAFLD曲线下面积为0.73,95%CI为(0.64,0.82),最佳截断值为18.50,其灵敏度为86.1%,特异度为53.8%;ALT单独预测NAFLD曲线下面积为0.81,95%CI为(0.73,0.88),最佳截断值为21.50,其灵敏度为84.7%,特异度为63.5%;WBC单独预测NAFLD曲线下面积为0.61,95%CI为(0.51,0.91),最佳截断值为7.64,其灵敏度为51.4%,特异度为67.3%;三者联合预测NAFLD曲线下面积为0.84,95%CI为(0.76,0.91),其灵敏度为86.1%,特异度为69.2%。结论SUA与儿童肥胖合并NAFLD存在相关性,低水平SHBG为肥胖合并NAFLD儿童的独立危险因素,可作为NAFLD的预测指标。

Androgens and estrogens in skeletal sexual dimorphism

Bone is an endocrine tissue expressing androgen and estrogen receptors as well as steroid metabolizing enzymes. The bioactivity of circulating sex steroids is modulated by sex hormone-binding globulin and local conversion in bone tissue, for example, from testosterone （T） to estradiol （E2） by aromatase, or to dihydrotestosterone by 5（x-reductase enzymes. Our understanding of the structural basis for gender differences in bone strength has advanced considerably over recent years due to increasing use of （high resolution） peripheral computed tomography. These microarchitectural insights form the basis to understand sex steroid influences on male peak bone mass and turnover in cortical vs trabecular bone. Recent studies using Cre/LoxP technology have further refined our mechanistic insights from global knockout mice into the direct contributions of sex steroids and their respective nuclear receptors in osteoblasts, osteoclasts, osteocytes, and other cells to male osteoporosis. At the same time, these studies have reinforced the notion that androgen and estrogen deficiency have both direct and pleiotropic effects via interaction with, for example, insulin-like growth factor 1, inflammation, oxidative stress, central nervous system control of bone metabolism, adaptation to mechanical loading, etc., This review will summarize recent advances on these issues in the field of sex steroid actions in male bone homeostasis.

Association between sex hormone-binding globulin and kidney function in men: results from the SPECT-China study

Background::The association between sex hormone-binding globulin(SHBG)and renal function has rarely been reported in men.We aimed to investigate the above association in a community-based Chinese population.Methods::A total of 5027 men were included from the survey on prevalence for metabolic diseases and risk factors,which is a population-based study conducted from 2014 to 2016 in Eastern China.The estimated glomerular filtration rate(eGFR)was calculated according to the chronic kidney disease Epidemiology Collaboration equation.Low eGFR was defined as eGFR<60 mL·min-1·1.73 m-2.Results::After adjusting for age,smoking,metabolic factors,and testosterone,through increasing quartiles of SHBG,a significantly positive association between SHBG quartiles and eGFR was detected in men(Q1 vs.Q4,β-2.53,95%confidence interval-3.89,-1.17,Ptrend<0.001).Compared with the highest quartile of SHBG,SHBG in the lowest quartile was associated with 96%higher odds of low eGFR(odds ratio 1.96,95%confidence interval 1.10,3.48)in the model after full adjustment.According to the stratified analyses,the associations between a 1-standard deviation increase in serum SHBG and the prevalence of low eGFR were significant in men aged≥60 years old,waist circumference<90 cm,diabetes(no),hypertension(yes),dyslipidemia(no),and nonalcoholic fatty liver disease(no).Conclusions::Lower serum SHBG levels were significantly associated with lower eGFR and a higher prevalence of low eGFR in Chinese men independent of demographics,lifestyle,metabolic-related risk factors,and testosterone.Large prospective cohort and basic mechanistic studies are warranted in the future.

血清雌二醇及性激素结合蛋白水平对围绝经期妇女肌少症的诊断价值

目的研究血清雌二醇(Estradiol,E2)及性激素结合蛋白(Sex hormone-binding globulin,SHBG)对围绝经期妇女肌少症的诊断价值。方法选择2021年1月1日-2022年12月31日上海市普陀区利群医院收治的122例肌少症患者为肌少症组,选择同期126例健康体检者为非肌少症组。采用酶联免疫吸附法(Enzyme linked immunosorbent assay,ELISA)检测血清中E2、SHBG水平,分析E2、SHBG水平与肌少症发病风险的相关性。根据Logistic回归分析确定围绝经期妇女肌少症发病的危险因素。采用ROC曲线分析血清E2、SHBG水平对围绝经期妇女肌少症诊断的预测价值。结果与非肌少症组相比,肌少症组患者四肢骨骼肌质量指数(Appendicular skeletal muscle,ASMI)、握力、步速、血清E2与SHBG表达水平均降低,差异有统计学意义(P均<0.05),且两组E2与SHBG均呈正相关。Logistic回归分析显示患者年龄、血清E2与SHBG表达水平均为肌少症的发病因素(P<0.05)。随着年龄的增长,肌少症的发病率增长(P<0.05)。ROC曲线分析显示血清E2与SHBG表达水平对围绝经期妇女肌少症的诊断有较好地预测价值。结论血清E2与SHBG水平均为围绝经期妇女肌少症的发病因素,对肌少症有较好的诊断价值。

当归芍药散加味联合达英-35治疗多囊卵巢综合征临床研究

目的:观察当归芍药散加味联合达英-35治疗肾虚血瘀型多囊卵巢综合征(PCOS)的疗效及对血清性激素结合球蛋白(SHBG)、促肾上腺皮质激素(ACTH)水平的影响。方法:选取92例肾虚血瘀型PCOS患者为研究对象,按随机数字表法分为西药组及联合组各46例,西药组给予达英-35治疗,联合组予以当归芍药散加味联合达英-35治疗,2组均治疗3个疗程。比较2组临床疗效及不良反应发生情况,比较2组治疗前后中医证候积分、卵巢体积、子宫内膜厚度、子宫内膜磷脂酰肌醇3激酶(PI3K)、蛋白激酶B(Akt)、磷酸化Akt(p-Akt)蛋白表达及血清SHBG、ACTH水平的变化。结果:联合组总有效率为93.48%,西药组总有效率为78.26%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组月经周期、月经量、腰膝酸软或腰脊刺痛、头晕耳鸣、经行腹痛中医证候积分及总分均较治疗前下降(P<0.05),联合组上述5项中医证候积分及总分均低于西药组(P<0.05)。治疗后,2组两侧卵巢体积均较治疗前下降,子宫内膜厚度均较治疗前上升,差异均有统计学意义(P<0.05);治疗后,联合组两侧卵巢体积均小于西药组,子宫内膜厚度大于西药组,差异均有统计学意义(P<0.05)。治疗后,2组子宫内膜PI3K、Akt、p-Akt蛋白相对表达量均较治疗前升高(P<0.05),联合组均高于西药组(P<0.05)。治疗后,2组血清SHBG水平均较治疗前升高,ACTH水平均较治疗前下降,差异均有统计学意义(P<0.05);治疗后,联合组SHBG水平高于西药组,ACTH水平低于西药组,差异均有统计学意义(P<0.05)。联合组不良反应发生率为4.35%,西药组为13.04%,2组比较,差异无统计学意义(P>0.05)。结论:当归芍药散加味联合达英-35治疗肾虚血瘀型PCOS疗效显著,能通过调控PI3K/AKT信号通路调节生殖轴,缓解患者临床症状,纠正性激素紊乱。

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

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。

血清SHBG与SAA4联合检测对涂阴肺结核辅助诊断的价值

目的评价性激素结合球蛋白(SHBG)、血清淀粉样蛋白4(SAA4)两项指标联合检测对涂阴肺结核的诊断预测价值。方法采集2017年3-5月广西柳州市龙潭医院收治的88例涂阴肺结核患者的血清标本,同一时期采集56例广西柳州市本地区的健康体检人员的血清标本作为健康对照组,采用酶联免疫吸附试验(ELISA)法检测涂阴肺结核组和健康对照组血清中SHBG、SAA4蛋白水平,应用受试者工作特征(ROC)曲线比较两者单一与联合诊断涂阴肺结核的效能,并与近三年相关涂(菌)阴肺结核的结核感染T细胞斑点试验(T-SPOT.TB)检测方法的诊断效能进行比较。结果涂阴肺结核组的血清SHBG、SAA4浓度分别为52.32(24.58~81.19)nmol/L和56.71(41.87~77.57)ng/mL,健康对照组的血清SHBG、SAA4浓度分别为25.97(16.60~36.45)nmol/L和35.79(29.81~41.07)ng/mL,涂阴肺结核患者血清SHBG、SAA4表达水平高于健康对照组,差异均有统计学意义(均P<0.001)。SHBG、SAA4单项及联合诊断涂阴肺结核的ROC曲线下面积分别为0.781、0.829、0.906(均P<0.001),两者联合诊断涂阴肺结核的灵敏度和特异度分别为84.1%、91.1%,约登指数为0.752。与近三年已报道涂(菌)阴肺结核T-SPOT.TB检测方法的诊断效能相比,SHBG与SAA4两者联合诊断涂阴肺结核具有优势。结论SHBG、SAA4对涂阴肺结核具有良好的辅助诊断价值,联合检测有利于提高涂阴肺结核的诊断率。

HbA1c、GSP、SHBG、TG、FFA对妊娠期糖尿病的诊断价值研究

目的探讨糖化血红蛋白(HbA1c)、糖化血清蛋白(GSP)、性激素结合球蛋白(SHBG)、三酰甘油(TG)、游离脂肪酸(FFA)在妊娠期糖尿病(GDM)诊断中的临床价值。方法选取2015年2月至2016年8月收治的GDM患者103例和健康孕妇98例分别作为GDM组和对照组,比较两组HbA1c、GSP、SHBG、TG、FFA水平和阳性检出率,并对各指标诊断效能进行分析。结果 GDM组HbA1c、GSP、TG、FFA水平明显高于对照组,而SHBG水平明显低于对照组,差异有统计学意义(P<0.05);GDM组HbA1c、GSP、SHBG、TG、FFA阳性率明显高于对照组,差异有统计学意义(P<0.05);HbA1c、GSP、SHBG、TG、FFA联合诊断GDM的特异度、灵敏度和阳性预测值均明显高于各单项指标,差异有统计学意义(P<0.05)。结论 HbA1c、GSP、SHBG、TG、FFA联合诊断GDM更为准确,具有重要临床价值,可作为GDM辅助诊断指标。

补肾调经育子汤联合来曲唑对肾虚血瘀型多囊卵巢综合征不孕患者卵泡发育及血清性激素结合球蛋白水平的影响

目的探讨补肾调经育子汤联合来曲唑对肾虚血瘀型多囊卵巢综合征(PCOS)不孕患者卵泡发育及血清性激素结合球蛋白(SHBG)水平的影响,并探讨其临床治疗效果。方法选取2017年2月至2019年2月青海省第四人民医院收治的78例肾虚血瘀型PCOS不孕患者作为研究对象。按就诊顺序随机分为观察组(n=39)和对照组(n=39)。对照组采用来曲唑治疗,观察组采用补肾调经育子汤联合来曲唑治疗。观察两组治疗后卵泡发育情况,比较两组血清SHBG、内脂素(visfatin)、促黄体素(LH)、睾酮(T)、LH/促卵泡激素(LH/FSH)水平,比较两组临床疗效与不良反应情况。结果治疗后,观察组卵泡直径、成熟卵泡个数及优势卵泡数均高于对照组,差异具有统计学意义(P<0.05)。观察组治疗后血清SHBG水平高于对照组,visfatin水平低于对照组,差异具有统计学意义(P<0.05)。观察组治疗后血清LH、T、LH/FSH水平均低于对照组,差异具有统计学意义(P<0.05)。观察组总有效率高于对照组,差异具有统计学意义(P<0.05)。治疗过程中,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论补肾调经育子汤联合来曲唑治疗肾虚血瘀型POCS不孕患者临床效果显著,可明显改善血清SHBG、visfatin水平,促进排卵,改善卵泡发育,且不良反应少。

Apolipoprotein B/Apolipoprotein A1 ratio is associated with sex hormone binding globulin and may be an indicator of metabolic syndrome in PCOS women

Objective To identify significant factors related to the apolipoprotein B/apolipoprotein A1 （apoB/A1） ratio and investigate the association between the apoB/A1 ratio and metabolic syndrome （MS） in polycystic ovary syndrome （PCOS） women. Methods Totally 307 subjects with PCOS were collected and recruited fulfilling the revised 2003 Rotterdam diagnostic criteria. MS was diagnosed by the National Cholesterol Education Program-Adult treatment Panel （NCEP-ATP） III criteria. Results The prevalence of MS in PCOS women was 31.6%, whose average age was 26.2 ___＋ 5.2 years. The apoB/A1 ratio was significantly correlated with age, body mass index （BM1）, waist circumference （WC）, hip circumference, waist-to-hip ratio, blood pressure, metabolic abnormalities, sex hormone binding globulin （SHBG）, and free androgen index. In addition, SHBG had a significant association with all five component risk of MS. The increasing apoB/A1 ratio was associated with the prevalence of MS and was one of the risk factors of MS. Conclusion SHBG was considered as an additional potential factor in predicting the metabolic abnormity in PCOS women. The apoB/A1 ratio is associated with SHBG and might be an indicator of MS in PCOS women.

多囊卵巢综合征患者妊娠早期血清Resistin水平与不良妊娠结局

目的:探讨多囊卵巢综合征(PCOS)孕妇妊娠早期血清抵抗素(Resistin)表达特征及与不良妊娠关系。方法:选取54例PCOS孕妇和100例健康孕妇分别作为病例组与对照组。在孕早期行血清Resistin、性激素结合球蛋白(SHBG)、空腹血糖(FPG)、空腹胰岛素(FINS)水平检测并分析与不良妊娠结局关系。结果:病例组血清Resistin、HOMA-IR值均高于对照组,SHBG水平低于对照组(P<0.05)。病例组妊娠结局良好者的Resistin、HOMA-IR水平均低于不良者,SHBG水平高于不良者(P<0.05)。病例组不良妊娠结局与妊娠早期血清Resistin、HOMA-IR水平呈正相关(r=0.416、0.316,P<0.05),与血清SHBG水平呈负相关(r=-0.307,P<0.05),血清Resistin水平相关程度最强。结论:PCOS孕妇妊娠早期血清Resistin水平升高且与妊娠并发症、不良妊娠结局有正相关关系,SHBG和HOMA-IR也可作为预测PCOS患者不良妊娠结局的参考指标。

Postprandial triglyceride metabolism in elderly men with subnormal testosterone levels

Aim： To investigate the level of postprandial triglycerides （TG）s in elderly men with subnormal testosterone level （≤ 11.0 nmol/L） compared to men with normal testosterone level （〉 11.0 nmol/L）. Methods： Thirthy-seven men with subnormal and 41 men with normal testosterone aged 60-80 years underwent an oral fat load and TG levels were measured fasting and 2, 4, 6 and 8 h afterwards. Results： Men with subnormal testosterone had significantly higher body mass index （BMI） and waist circumference （P 〈 0.001） than men with normal testosterone. They had significantly higher area under curve （AUC, P = 0.037）, incremental area under curve （AUCi, P = 0.035） and TG response （TGR, P = 0.014） for serum-TG and significantly higher AUC （P = 0.023）, AUCi （P = 0.023） and TGR （P = 0.014） for chylomicron-TG compared to men with normal testosterone level. Adjusting for waist circumference erased the significant differences between the groups in postprandial triglyceridemia. Conclusion： Men with subnormal testosterone have increased postprandial TG levels indicating an impaired metabolism of postprandial TG-rich lipoproteins （TRL）, which may add to an unfavourable lipid profile and promote development of atherosclerosis.

Association between SHBG(TAAAA)n and AR(CAG)n polymorphisms and PCOS risk: A meta-analysis

AIM: To systematically assess the association between sex hormone-binding globulin(SHBG)(TAAAA)n and androgen receptor(AR)(CAG)n polymorphisms and polycystic ovarian syndrome(PCOS) risk.METHODS: We searched MEDLINE(PubM ed), EMBASE and Web of Science database from inception to May2014. To avoid missing any additional studies, we looked through all the references of relevant articles. Case-control studies concerning the(CAG)n variants in the AR gene or the(TAAAA)n polymorphism in the SHBG gene in PCOS patients were included. Five studies regarding the(TAAAA)n polymorphism in the SHBG gene and 14 studies regarding the(CAG)n polymorphism in the AR gene met our criteria. Odd ratio(OR) and weighted mean difference(WMD) were selected as the effect size measurements to evaluate the influence of the(TAAAA)n polymorphism and(CAG)n variants on PCOS risk. Begg's test was used for the evaluation of publication bias.RESULTS: With respect to the relationship between the(TAAAA)n polymorphism and PCOS risk, the statistical results showed that there was no significant difference between PCOS patients and controls in the alleles of TAAAA(S: OR = 0.91, 95%CI: 0.78-1.05; L: OR = 1.10, 95%CI: 0.95-1.27). Subgroup analyses of the combination of alleles indicated similar results(shortshort: OR = 0.87, 95%CI: 0.66-1.14; short-long: OR = 1.12, 95%CI: 0.86-1.46; long-long: OR = 1.03, 95%CI: 0.72-1.47). As for the relationship between the(CAG)n polymorphism and PCOS risk, we found no association between CAG repeat variants and PCOS risk(WDM = 0.03, 95%CI:-0.13-0.08). Subgroup analyses by race and diagnosis criteria indicated the same results(Asian: WMD =-0.03, 95%CI:-0.14-0.07; Caucasian: WMD =-0.02, 95%CI:-0.24-0.21; the criteria of Rotterdam: WMD = 0.01, 95%CI:-0.01-0.03). CONCLUSION: There is no association between(TAAAA)n polymorphism in SHBG gene,(CAG)n repeat variants in AR gene and PCOS.

男性糖尿病患者血清性激素结合球蛋白水平与骨矿物质密度的相关性研究

目的:探讨男性糖尿病患者血清性激素结合球蛋白水平与骨矿物质密度的相关性。方法:本次试验选取2019年1月—2021年1月南方科技大学医院收治的86例男性糖尿病患者作为研究组,并选取同时期收治的46例男性健康体检者作为对照组,对比两组受试者基础资料和血清性激素结合球蛋白水平,分析与骨矿物质密度的相关性。结果:研究组BMI、FPG、FINS、UA及HOMA-IR水平高于对照组,差异有统计学意义(t=4.917、12.837、10.879、2.196、11.620,P<0.05);研究组FSH、LH、T、E及E2/T水平高于对照组,差异有统计学意义(t=6.319、14.290、3.066、14.020、12.690,P<0.050.05);腰椎L、L、L、股骨颈、大转子、华氏三角及髋部整体骨密度与年龄呈负相关,(r=-0.310、-0.285、-0.306、-0.391、-0.283、-0.247、-0.365,P<0.05);血清E、血清FT与全髋骨密度及腰椎L-L、25-羟维生素D呈正相关(P<0.05),血清E、血清FT与尿NTX及BALP呈负相关(P<0.05)。结论:男性糖尿病患者代谢变化的表征指标为血清性激素结合球蛋白水平,与骨矿物质密度具有相关性。

滋肾育胎丸对PCOS不孕患者血清性激素结合球蛋白、血清淀粉样蛋白P水平及内膜容受性的影响

目的 探讨滋肾育胎丸对多囊卵巢综合征(PCOS)合并不孕患者血清性激素结合球蛋白(SHBG)、血清淀粉样蛋白P(SAP)水平及子宫内膜容受性的影响,以期为PCOS合并不孕患者的治疗提供新的思路。方法 选择2021年1月至2023年12月期间西北妇女儿童医院收治的102例PCOS合并不孕患者为研究对象。采用随机数字表法,将患者分为研究组(采用来曲唑+滋肾育胎丸干预,51例)和对照组(仅采用来曲唑干预,51例)。检测两组患者治疗前后的SAP、SHBG水平、性激素(FSH、LH、雌二醇)水平、子宫内膜厚度、切面卵泡数目及卵巢间质面积/卵巢总面积(SA/TA),记录两组患者治疗后的排卵率、临床妊娠率、早孕流产率。结果 两组患者的年龄、体质量指数(BMI)、不孕类型、不孕年限比较均无显著性差异(P>0.05)。治疗前,两组患者间血清SHBG、SAP及性激素水平、子宫内膜厚度/类型、卵巢超声表现等指标比较均无显著性差异(P>0.05)。治疗后,研究组患者血清SHBG、LH水平显著高于对照组(P<0.05),SAP水平显著低于对照组(P<0.05),而两组患者间血清FSH、雌二醇水平比较无显著性差异(P>0.05)。治疗后,研究组患者子宫内膜厚度显著高于对照组患者(P<0.05),子宫内膜A型占比显著大于对照组(P<0.05),双侧卵巢的平均体积、SA/TA和卵泡数目均显著低于对照组(P<0.05)。治疗后,研究组的临床妊娠率(28.33%vs.12.70%)、排卵率(86.67%vs.69.84%)显著高于对照组(P<0.05),流产率(10.00%vs.25.40%)则显著低于对照组(P<0.05)。结论 滋肾育胎丸能有效调整PCOS合并不孕患者的SAP、SHBG水平,改善子宫内膜容受性。

Association of symptomatic late-onset hypogonadism and lower urinary tract symptoms in aging males: a community-based study

Objective:Testosterone deficiency may be a risk factor for lower urinary tract symptoms(LUTS),and there may be a causal ink between the emergence of LUTS and the incidence of late-onset hypogonadism(LOH).We perfomed an epidemiologic study to investigate the association between symptomatic late-onset hypogonadism(SLOH)and LUTS in middle-aged and elderly rural Chinese males.Methods:A total of 965 men completed a questionnaire and underwent a detailed physical examination.The Aging Males'Symptoms(AMS)scale was used to assess SLOH,and the International Prostate Symptom Score(IPSS)questionnaire was used to assess LUTS.Serum reproductive hormone levels of testosterone,sex hormone-binding globulin(SHBG)and luteinizing hormone(LH)were measured.Results:A total of 965 males(mean age:56.34±8.85,range:40-80 years)were recruited for the present study.A total of 20.93%(202/965)were diagnosed with SLOH.A total of 93.16%(899/965)had mild LUTS,5.18%(50/965)had moderate LUTS,and 1.66%(16/965)had severe LUTS.Among SLOH patients,13.40%(27/202)and 3.90%(8/202)had moderate and severe LUTS,respectively.Patients with severe LUTS had increased SHBG and LH compared with those with mild and moderate LUTS(P<0.01).Correlation analysis revealed that the AMS total score was positively correlated with the IPSS score(P<0.05).The prevalence of SLOH was significantly increased with LUTS severity In addition to the known effect of age,the results of mutiple regression analysis also showed that serum LH or SHBG appeared to have a weak link with SLOH and LUTS that requires etiological and biological clarification in our future study.Conclusion:In this cross-sectional analysis of SLOH and LUTS,LUTS severity was significantly associated with hypogonadism symptoms.Additionally,the prevalence of SLOH advanced with increasing LUTS severity.Serum SHBG or LH showed a positive correlation with SLOH and LUTS.

中老年男性血清睾酮、游离睾酮、双氢睾酮和性激素结合球蛋白含量的变化

目的 观察中老年男性血清睾酮(T)、游离睾酮(FT)、双氢睾酮(DUT)和性激素结合球蛋白(SHBG)的浓度,研究雄激素与增龄的关系。方法 129例45岁以上健康男性,可能有影响雄激素分泌的疾病和药物者已除外。按年龄分为4组。采用酶标免疫法测定T、FT、DHT和SHBG血清浓度。数据用SPSS软件包分析处理。结果 各年龄组之间,T的差别有显著性意义(P<0.05);而FT、DHT和SHBG的差别都具有非常显著性意义(P<0.01)。除了T(P>0.05),增龄与血清FT、DHT和SHBG浓度均明显相关(P<0.01)。结论 男性在中老年期随着年龄的增长,血清T浓度变化不明显,而FT和DHT浓度明显下降,SHBG浓度则明显上升。

性激素结合球蛋白基因启动子(TAAAA)n重复多态及其血清水平与多囊卵巢综合征糖代谢的关联性

目的探讨性激素结合球蛋白(sex hormore-binding globulin,SHBG)基因启动子(TAAA)n重复多态基因型分布及其血清水平与山东汉族多囊卵巢综合征(polycystic ovary syndrome,PCOS)不同糖代谢状态的关联性.方法基因片段分析加测序法检测156名正常育龄妇女及157例糖耐量正常的非胰岛素抵抗(no-insulin resisant,NIR)组、高胰岛素血症(hyperinsulinemia,HI)组与糖耐量异常的糖代谢异常(abnor-mal glucose metabolic,AGM)3组PCOS患者多态片段长度及重复次数;免放法测定部分对象血清SHBG水平.结果(1)检测到(TAAAA)6～10次重复5个等位基因及6/6、6/7、6/8、6/9、6/10、7/7、7/8、7/9、7/10、8/8、8/9、8/10、9/9、9/10重复14种基因型.(2)SHBG(TAAA)n多态基因型分布:6/10重复型对照组高于PCOS组(P＜0.01);8/9重复型PCOS组高于对照组(P＜0.01);小于8次重复的短多态基因型频率NIR组明显高于HI组(P＜0.05);7/9重复基因型AGM组高于NIR、HI组(P＜0.05;P＜0.01).(3)血清SHBG水平:纯合子8/8组＞9/9组＞6/6、7/7重复组,且其水平降低与肥胖、胰岛素抵抗程度加重及血压增高趋势一致;AGM、HI组＜NIR组＜对照组.结论 (1)山东汉族SHBG基因启动子(TAAAA)n重复多态等位基因、基因型及其数目与国外报道不同.(2)不同的特定(TAAAA)n重复多态基因型、低血清SHBG水平可能与PCOS及其糖代谢有关;(3)SHBG血清水平可能与特定基因型有关,尚需进一步阐明;但二者均不是PCOS糖代谢异常最敏感的指标.