Abstract
Sex hormone-binding globulin (SHBG) negatively associates with pre-gestational body mass index (BMI) and gestational weight gain. The link with other cardio-metabolic risk factors in pregnant women is poorly understood. Our aim was to study the association of SHBG levels with common cardio-metabolic risk parameters in pregnant woman.Serum SHBG was quantified in 291 Caucasian pregnant women (142 with normal weight, 42 with pregestational obesity, 50 with gestational obesity and 57 with pregestational plus gestational obesity) with uncomplicated pregnancies and parturition. Cardio-metabolic [C-reactive protein (CRP), blood pressure (BP), glycosylated hemoglobin (HbAc1), glucose, C-peptide, insulin, triglycerides and high molecular weight (HMW) adiponectin], and endocrine [testosterone and estradiol] parameters were also assessed.SHBG was negatively correlated with BMI, but also with CRP, BP, HbAc1, pre and post-load glucose, C-peptide, HOMA-IR, triglycerides; and positively with HMW adiponectin (all p<0.01 to p<0.0001). These associations were more robust in women with pregestational plus gestational obesity, who had lower SHBG, in comparison to normal-weight women (p<0.0001). In multivariate analyses in women with pregestational plus gestational obesity SHBG showed independent associations with CRP (β = −0.352, p = 0.03, R2 = 8.0%), DBP (β = −0.353, p = 0.03, R2 = 7.0%) and SBP (β = −0.333, p = 0.04, R2 = 6.0%) independently of BMI and metabolic and endocrine parameters.SHBG is decreased in pregnant women with pregestational plus gestational obesity in association with common cardio-metabolic parameters. SHBG could represent an integrating biomarker for an adverse cardio-metabolic profile in pregnant women with pregestational plus gestational obesity.
Highlights
Obesity is a well-known worldwide epidemic condition that affects men, women and children
Sex hormone binding globulin (SHBG) production is negatively regulated by insulin and monosaccharides and numerous studies in men, children and adolescents have shown that SHBG levels are reduced in obesity, insulin resistance, metabolic syndrome and type 2 diabetes [12,13]
SHBG levels are decreased in pregnant women with pregestational plus gestational obesity and are correlated with a less favorable cardio-metabolic profile
Summary
Obesity is a well-known worldwide epidemic condition that affects men, women and children. Offspring of obese women have increased risk of obesity and obesity-related negative health outcomes later in life, such as increased carotid-intima thickness, higher body mass index, increased blood pressure or adverse lipid profile throughout childhood, adolescence, and as young adults [2,3]. SHBG production is negatively regulated by insulin and monosaccharides and numerous studies in men, children and adolescents have shown that SHBG levels are reduced in obesity, insulin resistance, metabolic syndrome and type 2 diabetes [12,13]. A low level of SHBG may be a biomarker for the future development of metabolic risk factors (including hypertension, dyslipidemia, abdominal obesity and impaired glucose metabolism), and has been associated with a 2-fold increased risk of cardiovascular disease (CVD) [14]. In postmenopausal women, low SHBG levels are related to an adverse profile of risk factors for CVD [15]
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