2型糖尿病患者血清性激素结合球蛋白及相关激素测定的临床意义

目的探讨2型糖尿病（T2DM）患者血清性激素结合球蛋白（SHBG）及相关激素改变的临床意义。方法检测30例正常人（男、女各15例）和60例T2DM患者（男、女各30例）的SHBG、睾酮（T）和游离睾酮（F—T）浓度，以空腹血糖和血清胰岛素乘积之倒数作为胰岛素敏感性指数（ISI）。结果T2DM患者中血清SHBG水平降低。女性患者巾血清F—T水平升高。伴有肥胖的T2DM患者的上述变化更为明显。相关性分析显示：T2DM患者中ISI与血清SHBG呈正相关．女性患者ISI与F—T水平呈负相关。结论T2DM患者中SHBG减低，肥胖与胰岛素抵抗有关。在女性患者中雄激素增多也可引起胰岛素抵抗。     

2型糖尿病患者血清性激素结合球蛋白及相关激素测定的临床意义

目的探讨2型糖尿病(T2DM)患者血清性激素结合球蛋白(SHBG)及相关激素改变的临床意义.方法检测30例正常人(男、女各15例)和60例T2DM患者(男、女各30例)的SHBG、睾酮(T)和游离睾酮(F-T)浓度,以空腹血糖和血清胰岛素乘积之倒数作为胰岛素敏感性指数(ISI).结果 T2DM患者中血清SHBG水平降低,女性患者中血清F-T水平升高,伴有肥胖的T2DM患者的上述变化更为明显.相关性分析显示:T2DM患者中ISI与血清SHBG呈正相关,女性患者ISI与F-T水平呈负相关.结论T2DM患者中SHBG减低,肥胖与胰岛素抵抗有关,在女性患者中雄激素增多也可引起胰岛素抵抗.     

性激素结合球蛋白在妇产科疾病中的应用研究进展

性激素结合球蛋白（S HBG ）是主要由肝细胞合成的一种能结合性激素的球蛋白,也称睾酮-雌激素结合球蛋白或甾体结合蛋白。其主要生理功能是特异性结合转运性激素,调控血液中具有生物活性的性激素浓度,影响其生物利用度,并且与机体多种疾病的病理、生理状态有着相当密切的关系。本文将对SHBG及其在妇产科疾病中的应用做一综述,报道如下。     

上海地区成年男性血清睾酮、黄体生成素、性激素结合球蛋白变化趋势研究

正雄激素在男性中不仅起了维持男性性征,决定性生活及生殖作用,且与人体的肌肉、骨骼、血液、神经系统等全身各个器官功能间都有密切关系。近年来,中老年男性的生殖健康问题已成为全社会关注的热点,男性迟发性性腺功能减退症(late onset hypogonadism,LOH)也逐渐成为备受关注的问题之一,成年男性一生中雄激素水平的变化趋势也成为了研究热点。本研究选取上海市第六人民医院各年龄阶层     

肝硬化患者性激素变化的研究

目的 :探讨肝硬化患者性激素的变化。方法 :应用放免法分析 32例肝硬化患者血浆性激素水平 ,并与正常对照组比较。结果 :32例患者血浆睾酮 (T)均值为 17 0 6± 2 49nmol/L ,雌二醇 (E2 )均值为 0 18± 0 0 4nmol/L ,E2 /T平均比值为 0 0 38± 0 0 2 9,均明显高于对照组。失代偿期肝硬化患者的性激素紊乱重于代偿期肝硬化患者 ,血浆T降低 ,E2 增高与血清白蛋白降低相一致。结论 :肝硬化患者血浆T降低 ,E2 增高和E2 /T比值失衡反映出睾丸分泌功能降低和外周转化增多。     

性激素结合球蛋白与代谢性疾病相关性的研究进展

作为性激素转运的载体蛋白,性激素结合球蛋白(sex hormone-binding globulin,SHBG)通过多种途径参与人体内代谢过程,这导致了SHBG水平在代谢性疾病中的异常表达。在代谢综合征、糖尿病、骨质疏松性骨折等一些疾病中,低水平的SHBG被证实是发生这些疾病的独立风险因子。但关于SHBG与心血管疾病之间的联系,尚未取得完善的结论,有待进一步的研究。     

性激素结合球蛋白在妇产科疾病临床检验中的应用

目的妇产科疾病在进行临床检验的过程中,性激素结合球蛋白可能会产生一定的影响,文章探究这一影响的效果和相关的因素。方法现在2018年期间进入5月份检验的102位孕产妇作为研究主体,在怀孕至24-28周的时候展开葡萄糖耐量的实验测试,结合测试结果将其中51位正常孕产妇划为对照组,另外51例妊娠期的糖尿病产妇化为观察组,对两组产妇之间的身体质量指数、血脂、血糖等相关的指标和健康参数进行收集并统计成数据信息,都是检测线激素结合球蛋白的含量水平。结果经过检验可以发现对照组和观察组之间血液指标和相关的健康参数之间都出现了显著差异。结论性激素结合球蛋白的含量水平在妇产科疾病的作用机制当中起到重要作用和疾病的检测有着相对密切的关系,因而对于相关疾病的预测过程有着重要的现实意义。     

男性2型糖尿病患者血清睾酮、雌二醇、性激素结合蛋白的变化

目的：观察男性2型糖尿病患者血清总睾酮、总雌二醇、性激素结合蛋白的变化，探讨该种变化与男性2型糖尿病及其并发症发生的关系。方法：①选择2003-10／2005-06在中南大学湘雅二医院代谢内分泌研究所门诊就诊及住院男性2型糖尿病患者89例为男性糖尿病组，年龄40—60岁。选择同期本院健康体检男性66人为男性对照组，年龄40-60岁。均对检测项目知情同意。②采用葡萄糖氧化酶法测定血糖，采用酶联免疫吸附法测定血清总睾酮、总雌二醇、性激素结合蛋白、胰岛素水平。（3）计量资料差异分析采用t检验；胰岛素与性激素的关系用直线相关分析。结果：男性2型糖尿病患者89例，健康男性66人均进入结果分析。①男性2型糖尿病组空腹血糖、餐后120min血糖、空腹胰岛素和餐后120min胰岛索、血清总雌二醇、性激素结合蛋白水平均明显高于男性对照组（P〈0．05）。男性糖尿病组血清总睾酮水平明显低于男性对照组（P〈0．05）。（2）血清空腹胰岛素、餐后120min胰岛素与总睾酮、总雌二醇、性激素结合蛋白无明显相关性（P〉0．05）。结论：①血浆性激素是反映男性2型糖尿病患者代谢变化的指标之一。②男性2型糖尿病患者人体内存在性激素分泌功能紊乱，其改变可对糖尿病及其并发症的发生发展起重要作用。     

男性胆囊胆固醇结石患者性激素、性激素结合球蛋白及胰岛素抵抗的相关性研究

目的探讨性激素结合球蛋白、性激素、胰岛素抵抗与男性胆囊胆固醇结石的关系。方法测定30例男性胆囊胆固醇结石患者与30例健康志愿者性激素结合球蛋白(SHBG)、雌二醇(E2)、游离睾酮(FT)、总睾酮(TT)、空腹胰岛素(FINS)、空腹血糖(FBG)水平,同时监测患者血压,计算体质指数、腰/臀比和胰岛素抵抗指数(HOMA-IR),并进行比较。结果①结石组腰/臀比、胰岛素、HOMA-IR、E2/T[(0.90±0.03)、(7.02±3.28)mU/L、(1.63±0.86)、(7.23±0.08)]较对照组[(0.86±0.05)、(4.39±1.34)mU/L、(1.01±0.35)、(3.15±0.02)]高(均P<0.01),结石组SHBG[(123.07±50.79)nmol/L]较对照组[(156.77±72.82)nmol/L]低(P<0.05),FT、TT[(9.97±3.86)ng/L、(7.79±3.67)nmol/L]较对照组[(14.04±5.70)ng/L、(13.3±4.24)nmol/L]低(P<0.01),而E2值无差异(P>0.05)。②男性胆囊胆固醇结石发病与FT、TT、SHBG呈负相关,与E2/T、空腹胰岛素、HOMA-IR呈正相关。③多因素分析提示腰/臀比、TT、FINS、空腹血糖为男性胆囊胆固醇结石发病的危险因素。结论①男性胆囊胆固醇结石患者存在性激素不平衡,主要是TT、FT、SHBG降低及E2/T比值增高,TT是男性胆囊胆固醇结石发病的危险因素。②男性胆囊胆固醇结石患者空腹胰岛素水平较对照组高,且高胰岛素血症是男性胆囊胆固醇结石患者发病危险因素。③男性胆囊胆固醇结石患者SHBG、FT水平降低可能与男性胆囊胆固醇结石患者体脂分布异常及空腹胰岛素水平升高有关。     

绝经后女性脑梗死患者血清性激素结合球蛋白的检测及其意义

目的 探讨血清性激素结合球蛋白（SHBG）在绝经后女性脑梗死患者发病过程中的变化及其意义。方法 采用放免法动态测定30例绝经后女性脑梗死患者及30例健康体检者血清SHBG的水平，分析其与脑梗死的关系。结果 绝经后女性脑梗死患者急性期血清SHBG明显高于恢复期及健康对照组。差异有显著性（均P〈0．01），而恢复期与健康对照组血清SHBG差异无显著性（P〉0．05）。结论 绝经后女性脑梗死患者急性期SHBG增高，而在恢复期恢复正常。这种变化是机体对脑梗死的一种适应性反应，有利于脑梗死的恢复。     

Comparative measurements of plasma binding capacity and concentration of human sex hormone binding globulin

Comparisons are made of the plasma binding capacity and concentration of sex hormone binding globulin. Concentration was measured by electroimmunodiffusion standardised in terms of mass of the protein and binding capacity by two methods measuring the binding of 5 alpha-dihydrotestosterone. Isolation of steroid bound by SHBG was by either ammonium sulphate precipitation or cellulose filter discs. Both binding methods correlate highly with electroimmunodiffusion indicating they respond similarly to changes in the plasma concentration of the protein. However, they do not equally reflect the actual concentration. Estimates of the molecular mass of the protein of 188000 and 100000 from the precipitation and disc methods respectively, suggest the former measures less of the protein present than does the latter. A parallel reduction in binding capacity and concentration is seen in obese post-menopausal females. This previously unreported finding suggests that the reduced plasma binding capacity of sex hormone binding globulin in obesity is not due to altered or impaired steroid binding.     

A method for the determination of sex hormone binding globulin in human serum

A simple and rapid method for serum sex hormone binding globulin (SHBG) was developed. Sera from pregnant women were pooled and the SHBG concentration was measured by Rosner's method. This pool was diluted with charcoal-treated and heated serum to give standards ranging in concentrations from 26.8-0.8 micrograms/L. Two sets of tubes containing dihydrotestosterone (DHT), assay and control tubes, were prepared. Diluted standards and unknowns were added to assay and control tubes along with tritiated DHT. Following incubation, cold saturated ammonium sulfate was added to each tube, mixed, centrifuged and the supernatant counted. Mean SHBG concentration (microgram/L +/- SEM) in normal men was 3.6 +/- 0.4, normal women 11.4 +/- 2.2, pregnant women 58 +/- 2.6, obese women 3.3 +/- 1.0, hirsute women 2.9 +/- 0.2, hypothyroid women 7.3 +/- 1.0, and hyperthyroid women 26.0 +/- 1.6. These results correlate well with previous reports. This method is fast, convenient, and up to 40 samples can be analyzed in one assay.     

多囊卵巢综合征患者性激素结合球蛋白和硫酸脱氢表雄酮的相关性分析

目的 探讨多囊卵巢综合征（PCOS）患者血清硫酸脱氢表雄酮（DHEAS）与性激素结合球蛋白（SHBG）的关系。方法 检测了45例PCOS患者血清空腹胰岛素、睾酮、DHEAS与SHBG的浓度,20例正常育龄期妇女作为对照。结果 PCOS患者血清空腹胰岛素、睾酮水平明显较对照组高（P〈0.05）,其DHEAS与SHBG的浓度存在负相关关系（P〈0.05）。结论 PCOS患者由于高胰岛素血症导致循环血SHBG的减少,进而使性激素水平发生紊乱,使PCOS患者表现为高雄激素血症、DHEAS与SHBG呈负相关关系。肾上腺激素DHEAS参与了PCOS的发生。     

Evaluation of automated sex hormone binding globulin immunoassays

BACKGROUND: Sex hormone binding globulin (SHBG) is an important regulator of testosterone and estradiol. STUDY DESIGN: We validated the Diagnostic Products Corporation (DPC) and Roche Diagnostic SHBG immunoassays on the DPC Immulite 2000 and Roche Modular E170 analyzers. RESULTS: The coefficient of variation for SHBG kits from both manufacturers was in the range of 3.9-7.7% (between-run) and 0.95-5.0% (within-run), free of interference from hemoglobin, bilirubin, lipid, and rheumatoid factor, and linear up to at least 170 nM SHBG. The results of the two methods, however, were biased by up to 29% depending on the SHBG concentration. CONCLUSION: The SHBG assays perform well but standardization is needed.     

Bone turnover markers and sex hormones in men with idiopathic osteoporosis

BACKGROUND: In contrast to osteoporosis in postmenopausal women, osteoporosis in men has received much less attention. PATIENTS AND METHODS: We determined various biochemical parameters of bone metabolism and sex hormones in 31 men with idiopathic osteoporosis and 35 age matched control subjects. RESULTS: In the men with osteoporosis, a significantly increased urinary excretion of deoxypyridinoline (5.3 +/- 0.2 vs. 4.6 +/- 0.2 nmol mmol-1 creatinine; P = 0.033) in addition to increased serum levels of the c-terminal telopeptide of type I collagen (2677 +/- 230 vs. 2058 +/- 153 pmol; P = 0.037) were found. While parameters of bone formation were not significantly different in the patients and controls, serum bone sialoprotein levels were significantly decreased in the patients (3.7 +/- 0.8 vs. 12.4 +/- 4.0 ng mL-1; P = 0.021). Moreover, in men with idiopathic osteoporosis, lower levels of estradiol (91.3 +/- 5.8 vs. 114.6 +/- 7.8 pmol L-1; P = 0.044), higher levels of sex hormone binding globulin (31.5 +/- 3.1 vs. 24.2 +/- 1.4 nmol L-1; P = 0.034) and a decreased free androgen index (42.6 +/- 5.2 vs. 56.4 +/- 5.9; P = 0.016) were seen. Serum estradiol levels correlated negatively with several parameters of bone resorption. CONCLUSIONS: In men with idiopathic osteoporosis, bone resorption is increased and exceeds bone formation. The excessive bone resorption seen in idiopathic male osteoporosis may be due to decreased estradiol levels and low levels of bioavailable testosterone.     

New reference intervals for cortisol,cortisol binding globulin and free cortisol index in women using ethinyl estradiol

Abstract

Healthy women using contraceptives containing a low dose of an estrogen may have a higher serum concentration of cortisol (s-cortisol) and cortisol binding globulin (s-CBG) than the commonly used upper reference limits. There are no published reference intervals for s-cortisol, s-CBG, serum free cortisol index (s-FCI) or cortisol in saliva (sa-cortisol) for these women. The aim was to establish the above-mentioned reference intervals and document the differences in s-cortisol and s-CBG in one group of women using and another group not using ethinyl estradiol (EE). In this cross-sectional study, the reference limits presented were given as the 2.5 and 97.5 percentiles of the distribution of reference values in a population of 277 healthy volunteer women, aged 18–45?years. 157 women were not using any type of estrogen, while 120 women were using contraceptives containing a daily dose of 15–35?μg of EE. Serum and salivary cortisol, and serum CBG were measured using standard laboratory methods. S-FCI was calculated as s-cortisol/s-CBG. The reference intervals for s-cortisol in samples collected at 0800–1030 am in women using and not using EE contraception were: 284–994?nmol/L and 159–569?nmol/L respectively, and for s-CBG: 847–3366?nmol/L and 860–1940?nmol/L, respectively. For s-FCI and sa-cortisol, no clinically significant differences were found. Sa-cortisol may be the preferred measurand for evaluation of possible hypercortisolism in women using estrogens, since cortisol in saliva is not influenced by estrogen. If assessing morning s-cortisol and s-CBG in women using EE, we recommend using separate – and not the commonly used – reference intervals.     

2型糖尿病患者绝经后血清性激素结合球蛋白与下肢血管病变的相关性

目的探讨血清性激素结合球蛋白水平(SHBG)与绝经后2型糖尿病(T2DM)患者下肢血管病变的相关性。方法选取150例绝经后T2DM患者,根据双下肢高分辨彩色多普勒检查分为单纯T2DM(A组)50例,合并轻度下肢动脉粥样硬化(B组)45例,合并重度下肢动脉粥样硬化(C组)55例;并选取同期来本院体检的45例绝经后健康者为对照(NC)组,对各组患者进行临床资料收集及常规生化指标检测,采用电化学发光法检测各组空腹血清SHBG及睾酮(T)、雌二醇(E2),促卵泡刺激素(FSH),黄体生成素(LH)水平,并分析SHBG与其他指标的关系。结果4组血清SHBG水平依次为:NC组[(60.4±8.8)μg/L]A组[(44.1±6.1)μg/L]B组[(33.6±4.9)μg/L]C组[(25.83±3.4)μg/L];T2DM组中,血清SHBG水平与HbA1c、TG、T、LDL-C、HOMA-IR负相关(r值分别为-0.605、-0.164、-0.351、-0.247、-0.649,P0.05);回归分析结果显示,校正混杂因素后,血清SHBG水平仍与糖尿病下肢血管病变相关(OR=1.674,P=0.001,95%CI:1.124~2.146)。结论低水平的SHBG是绝经后2型糖尿病患者下肢血管病变的危险因素之一。     

性激素结合球蛋白与老年男性冠状动脉粥样硬化关系的探讨

目的通过观察老年男性冠状动脉粥样硬化（CAS）的危险因素特别是代谢异常因素与性激素结合球蛋白（SHBG）的关系,探讨SHBG与CAS形成的关系。方法选择住院并接受冠状动脉造影检查的老年男性患者90例,根据冠状动脉造影结果分为冠状动脉病变组（75例）和冠状动脉正常组（15例）。入院24h内测定SHBG、空腹血糖和血脂指标等,比较组间差异并分析SHBG与其他代谢指标的相关关系以及SHBG与CAS的相关性。结果 SHBG在2组间差异具有统计学意义（P〈0.01）;SHBG与体重指数（BMI）、低密度脂蛋白胆固醇（LDL-C）以及空腹血糖具有负相关关系（r值分别为-0.239、-0.965和-0.272,P〈0.05）,与总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）以及高敏C反应蛋白（hs-CRP）之间未见显著的相关关系;空腹血糖、LDL-C以及SHBG是CAS发生的独立危险因素,其中SHBG的比值比（OR）为2.81。结论 CAS不同程度的老年男性患者SHBG浓度存在差异,低水平SHBG可能是CAS的一个独立危险因素。     

Sex hormone‐binding globulin levels are not causally related to venous thrombosis risk in women not using hormonal contraceptives

Summary. Background: Oral contraceptive use increases the risk of venous thrombosis as well as sex hormone‐binding globulin (SHBG) levels. Furthermore, increased SHBG levels are positively associated with activated protein C (APC) resistance and thrombotic risk in oral contraceptive users. Objectives: To determine whether increased SHBG levels are causally related to venous thrombosis in women not using hormonal contraceptives. Methods: Premenopausal women were selected from a case–control study on venous thrombosis, the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis (MEGA) study (23 patients; 258 controls). Women using hormonal contraceptives were excluded. First, the risk of venous thrombosis with SHBG levels above the normal reference range (70 nm ) was determined. Second, because multiple regulatory factors affect SHBG levels and residual confounding may remain, we determined six single‐nucleotide polymorphisms (SNPs) in the SHBG gene and assessed the risk of venous thrombosis in a different case–control study, the Leiden Thrombophilia Study (LETS) (20 patients; 74 controls), and in the MEGA study. Finally, the association between SHBG levels and the normalized activated partial thromboplastin time‐based APC resistance (an intermediate endpoint for venous thrombosis) was determined. Results: Elevated SHBG levels (> 70.0 nm ) were associated with venous thrombosis (odds ratio 1.92; 95% confidence interval [CI] 0.74–5.00). However, this finding can be explained by residual confounding. Two SNPs in the SHBG gene affected SHBG levels, but not venous thrombosis risk. Furthermore, SHBG levels in controls were not associated with APC resistance (SHBG level, > 70.0 vs. ≤ 70.0 nm : mean difference in normalized APC sensitivity ratio, 0.03; 95% CI ?0.05 to 0.10). Exclusion of women with FV Leiden did not materially change these results. Conclusions: Increased SHBG levels are not causally related to the risk of venous thrombosis.     

不同年龄多囊卵巢综合征患者性激素结合球蛋白与激素指标、血脂指标的相关性

目的 分年龄阶段探讨多囊卵巢综合征(PCOS)患者血清性激素结合球蛋白(SHBG)与空腹胰岛素(FINS)、硫酸脱氢表雄酮(DHEA-S)及血脂指标的相关性.方法 回顾性分析2017年1月1日至2019年8月30日在山东大学生殖医学研究中心就诊的3 349例PCOS患者的FINS、性激素和血脂指标,按照SHBG的参考值...