Association between sex hormone-binding globulin (SHBG) and metabolic syndrome among men.

Emmanuela Quental Callou De Sá,Francisco Carleial Feijó De Sá,Ieda Therezinha Nascimento Verreschi,Kelly Cristina Oliveira,Fausto Feres

doi:10.1590/1516-3180.2014.1322666

Emmanuela Quental Callou De Sá, Francisco Carleial Feijó De Sá + Show 3 more

Open Access

https://doi.org/10.1590/1516-3180.2014.1322666

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Abstract

Metabolic syndrome consists of a set of factors that imply increased risk of cardiovascular diseases. The objective here was to evaluate the association between sex hormone-binding globulin (SHBG), sex hormones and metabolic syndrome among men. Retrospective analysis on data from the study "Endogenous oestradiol but not testosterone is related to coronary artery disease in men", conducted in a hospital in São Paulo. Men (aged 40-70) who underwent coronary angiography were selected. The age, weight, height, waist circumference, body mass index and prevalence of dyslipidemia, hypertension and diabetes of each patient were registered. Metabolic syndrome was defined in accordance with the criteria of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP-ATPIII). Serum samples were collected to assess the levels of glucose, total cholesterol, HDL-cholesterol (high density lipoprotein), triglycerides, albumin, SHBG, estradiol and total testosterone (TT). The levels of LDL-cholesterol (low density lipoprotein) were calculated using Friedewald's formula and free testosterone (FT) and bioavailable testosterone (BT) using Vermeulen's formula. 141 patients were enrolled in the study. The prevalence of metabolic syndrome was significantly higher in the first SHBG tercile than in the second and third terciles. A statistically significant positive association between the SHBG and TT values was observed, but no such association was seen between SHBG, BT and FT. Low serum levels of SHBG are associated with higher prevalence of metabolic syndrome among male patients, but further studies are required to confirm this association.

Highlights

Metabolic syndrome consists of a set of factors that confer increased risk of cardiovascular diseases, including obesity, insulin resistance, dyslipidemia and systemic arterial hypertension (SAH)
Increased sex hormone-binding globulin (SHBG) levels were negatively associated with BMI, abdominal circumference and prevalence of diabetes (Table 1)
The prevalence of metabolic syndrome was significantly higher in the first SHBG tercile than in the second and third SHBG terciles (Table 2)

Summary

Introduction

Metabolic syndrome consists of a set of factors that confer increased risk of cardiovascular diseases, including obesity (especially abdominal obesity), insulin resistance (regardless of the presence of diabetes mellitus), dyslipidemia (increased triglyceride levels and reduced HDL cholesterol levels) and systemic arterial hypertension (SAH). Insulin is an important regulator of SHBG production in the liver. In vitro studies have shown that physiological concentrations of insulin inhibit SHBG production in cultured hepatoma cells.[2] Pasquali et al.[3] showed that inhibition of insulin secretion by means of diazoxide induces an increase in SHBG levels, both in obese men and in men with normal body weights. Men who present low SHBG concentrations are at increased risk of developing metabolic syndrome.[4] The prevalence of concomitant dyslipidemia, hypertension and diabetes suggests that insulin resistance may be a determinant of SHBG levels

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