1198-P: Sex Hormone Binding Globulin (SHBG) as an Indicator of Reduced Insulin Sensitivity in Type 1 Diabetes (T1D) Adults and a Potential Tool to Guide Adjunct Therapy

Abstract

Introduction: Excess adipose tissue, esp. with the metabolic syndrome (MetS) promotes development of type 2 diabetes (T2D) and cardiovascular disease (CVD). A major feature of MetS, reduced insulin sensitivity (IS), is associated with increased hepatic lipogenesis, a marker of which is a low SHBG. Features of T2D are increasingly common in T1D. Aim: In T1D adults to determine if SHBG is associated with surrogate measures of IS and MetS. Methods: Cross-sectional analysis of sera from 279 people (Table). Of those with T1D 41 had microvascular complications. SHBG was quantified by chemiluminescent immunoassay (Roche Diagnostics, Mannheim, Germany). IS in T1D was assessed by estimation of M/I by modified published formulae using sex, HDL-C, pulse pressure, T1D duration, waist/height, WHR, BMI and HbA1c. Results: SHBG levels were higher in T1D than in CON and also higher in F vs. M. SHBG levels correlated with age in CON and T1D. M/I in tertile 3 (sex and T1D adjusted) of SHBG was significantly higher vs. tertiles 1 and 2 (in CON and T1D). In T1D SHBG (age and sex adjusted) decreased with increasing number of MetS features. ROC curve for MetS diagnosis in T1D using SHBG had an AUC of 0.73. Conclusion: Taken together these data show that IS and MetS are associated with lower SHBG levels in T1D. We propose a role for SHBG in personalising insulin sensitiser treatment in T1D. Disclosure A. S. Januszewski: None. W. Rankin: None. D. N. O9neal: Advisory Panel; Self; Abbott Diabetes, Medtronic, Sanofi, Research Support; Self; Dexcom, Inc., GlySens Incorporated, Medtronic, Pacific Diabetes Technologies. G. A. Wittert: Advisory Panel; Self; Bayer AG, Research Support; Self; Bayer AG, Speaker9s Bureau; Self; Bayer AG. A. Jenkins: Advisory Panel; Self; Abbott Diabetes, Sanofi-Aventis, Other Relationship; Self; Amgen Inc., Research Support; Self; Abbott, International Diabetes Federation, JDRF, Medtronic, Mylan N. V.