Abstract
BackgroundSex hormone-binding globulin (SHBG), a glycoprotein synthesized by hepatocytes, has been linked to insulin resistance and hepatic lipid metabolism and is suggested to be associated with nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the association of SHBG with NAFLD in Chinese adults.MethodsWe conducted a community-based, cross-sectional study in China involving 2912 participants aged 40–75 years old. All participants underwent detection for hepatic fat infiltration by ultrasound in addition to providing complete medical history and undergoing physical and blood biochemical examinations. The association of serum SHBG with the presence of NAFLD was reported by adjusted odds ratio after applying logistic regression models. To further explore the relationship between SHBG and NAFLD, mRNA expression of SHBG and hepatocyte nuclear factor 4-α (HNF4α), as well as intrahepatic triglycerides, were determined from the liver tissues of 32 subjects with different degrees of steatosis.ResultsSerum SHBG levels in patients with NAFLD (median, 43.8 nmol/L; interquartile range, 33.4–56.8 nmol/L) were significantly lower than those in non-NAFLD subjects (median, 63.4 nmol/L; interquartile range, 47.6–83.1 nmol/L). Serum SHBG levels were inversely correlated with WHR, trunk fat percentage, glucose, HOMA-IR, TG, UA and DHEAS, and were positively correlated with HDL-C levels (all p < 0.001). Logistic regression analysis indicated that serum SHBG levels were negatively associated with the presence of NAFLD in all subjects, as well as the subgroups stratified by sex, BMI and HOMA-IR (all p < 0.05). In human liver tissues, SHBG and HNF4α mRNA expression decreased along with the elevated grade of hepatic steatosis. Both SHBG and HNF4α mRNA expression levels were negatively correlated with intrahepatic triglycerides.ConclusionsThese results demonstrate that SHBG levels were negatively associated with the presence of NAFLD in middle-aged and elderly Chinese adults.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is acknowledged as a global public health issue [1]
These results demonstrate that Sex hormone-binding globulin (SHBG) levels were negatively associated with the presence of nonalcoholic fatty liver disease (NAFLD) in middle-aged and elderly Chinese adults
Though a meta-analysis of associations between testosterone and SHBG and NAFLD which extracted data from 16 observational studies claimed that SHBG was lower in subjects with NAFLD compared to those without NAFLD [23], a significant heterogeneity was observed in the study (I2 = 99% in men, I2 = 97% in women, both p for heterogeneity < 0.01), which reduced the credibility of the conclusion
Summary
Nonalcoholic fatty liver disease (NAFLD) is acknowledged as a global public health issue [1]. Numerous publications have proposed that low levels of SHBG are strongly associated with the features of metabolic syndrome [11,12,13] and may play an important role in modifying the risk of insulin resistance and its outcomes [14,15,16]. Wang N et al demonstrated that lower levels of SHBG were associated with the presence of NAFLD in Chinese men and menopausal women [21]. It is still difficult to draw firm conclusions about the relationship between SHBG and NAFLD for people from the general population, especially when we discuss the problem in the Chinese population. Sex hormone-binding globulin (SHBG), a glycoprotein synthesized by hepatocytes, has been linked to insulin resistance and hepatic lipid metabolism and is suggested to be associated with nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the association of SHBG with NAFLD in Chinese adults
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