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Sex hormone-binding globulin a risk factor for cardiometabolic morbidity
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Lower sex hormone-binding globulin levels in women are associated with a higher risk for metabolic syndrome and type 2 diabetes, particularly in postmenopausal women, according to research in The Journal of Clinical Endocrinology & Metabolism.
In a longitudinal, population-based study of more than 2,000 German women, researchers did not find an association between total testosterone levels and type 2 diabetes and metabolic syndrome, a contrast to previous studies.
“We were able to demonstrate a statistically significant association between low SHBG levels and an increased [metabolic syndrome] risk after multivariable adjustment,” Benjamin Fenske, of the Institute of Clinical Chemistry and Laboratory Medicine in Greifswald, Germany, and colleagues wrote. “Although [total testosterone] showed no associations with incident [metabolic syndrome] or [type 2 diabetes], low SHBG and, therefore, high [free testosterone] levels were associated with incident type 2 diabetes in age-adjusted analysis.”
Fenske and colleagues analyzed data from 2,077 women (mean age, 48.8 years; mean BMI, 26.1 kg/m²; 23.1% with metabolic syndrome; 9.5% with type 2 diabetes) who participated in the Study of Health in Pomerania, a population-based study in northeastern Germany. Within the cohort, 1,111 women were premenopausal; 963 postmenopausal; 17.7% used oral contraceptives; and 9% were using hormone therapy. There were 1,711 women re-examined at 5-year follow-up between 2002 and 2006. Variables for type 2 diabetes and metabolic syndrome were measured at baseline and at follow-up.
Researchers used liquid chromatography tandem mass spectrometry-based measurements for endogenous androgens at baseline to assess a possible link between endogenous androgens, SHBG levels and cardiometabolic risk, noting the measurement was more accurate than hormone assessment based on immunoassay.
After multivariable adjustment, researchers found an inverse association between SHBG and metabolic syndrome (RR = 0.67; 95% CI, 0.6-0.74) and with type 2 diabetes (RR = 0.61; 95% CI, 0.5-0.74). In a longitudinal analysis, only age-adjusted models showed a link between baseline SHBG levels and metabolic syndrome (RR = 0.61; 95% CI, 0.51-0.73) and type 2 diabetes (RR = 0.58; 95% CI, 0.43-0.78). When stratified by menopausal status, there was an increased RR for postmenopausal women (RR = 0.65; 95% CI, 0.51-0.81).
Excluding women using oral contraceptives or HT did not alter the analysis, according to researchers. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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