Relationship between sex hormone-binding globulin levels and features of the metabolic syndrome

Hajamor, Samah; Després, Jean‐Pierre; Couillard, Charles; Lemieux, Simone; Tremblay, Angelo; Prud’homme, Denis; Tchernof, André

doi:10.1016/s0026-0495(03)00066-0

Cited by 75 publications

(69 citation statements)

References 36 publications

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“…However, if free androgens are known to give a better idea of the androgenic activity than TT, the proper role of SHBG should not be underestimated. SHBG has been found to be associated with lipoprotein levels in men [12], being positively related to HDL-C, and low plasma levels of SHBG were found to be a good marker of the metabolic syndrome features [13]. Moreover, according to the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) [14], the metabolic syndrome is defined in men by the presence of any three of the five following abnormalities: waist girth > 102 mm, HDL-C < 1.03 mmol/l, TG ≥ 1.69 mmol/l, fasting blood glucose ≥ 6.1 mmol/l and blood pressure ≥ 130/85 mmHg.…”

Section: Discussionmentioning

confidence: 99%

Sex hormone-binding globulin is a major determinant of the lipid profile: the PRIME study

et al. 2005

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The prevalence of coronary heart disease is much higher in men than in women and sex hormones might play a role in these differences through their influence on the lipid profile. The aim of this cross-sectional study was to study the relationship between hormonal markers (total testosterone (TT), estradiol (E2), sex-hormone-binding globulin (SHBG)) and plasma lipids in a population-based sample. Subjects were 352 men, 50-59 years old, selected in France (Lille, Strasbourg and Toulouse) and Northern-Ireland (Belfast) who had questionnaires and a medical examination at baseline of the PRIME prospective study (1991)(1992)(1993). Pearson correlation coefficients and Student's t tests were used to identify factors associated with plasma lipids. Multiple linear regression models were used for multivariate analyses, using triglycerides (TG) (log-transformed) and high density-lipoprotein cholesterol (HDL-C) as dependent variables. SHBG and TT were negatively correlated with TG (p < 0.0001 and p < 0.05, respectively) and positively correlated with HDL-C (p < 0.0001 and p < 0.01). E2 was positively correlated with TG (p < 0.05). No significant association was found between sex-hormones and LDL-C. In multiple linear regression analyses, SHBG remained independently associated negatively with TG (p < 0.01) and positively with HDL-C (p < 0.0001) after adjustment for centre of recruitment, age, body mass index, systolic blood pressure, smoking, alcohol intake and physical activity. After further adjustment for insulin, the association between SHBG and HDL-C remained highly significant (p < 0.0001). The association between SHBG and TG was weakened but remained also significant. Our results suggest that SHBG might to be a central protein in the hormonal regulation of the lipid profile.

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Section: Discussionmentioning

confidence: 99%

Sex hormone-binding globulin is a major determinant of the lipid profile: the PRIME study

et al. 2005

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“…28 Unlike other markers of insulin resistance, SHBG is reliable in the nonfasting state 29 and it exhibits no diurnal variation, 30 rendering SHBG a unique marker of insulin resistance that is especially useful in clinical situations when fasting blood samples are not routinely collected, such as during prenatal care. Furthermore, reduced levels of SHBG have been shown to independently identify women at risk for type 2 diabetes mellitus, 31,32 and recently, SHBG levels demonstrated good correlations with other manifestations of the metabolic syndrome including altered lipids, 33 which are also characteristic of women with preeclampsia. 34 We have shown that low first trimester levels of SHBG are independently associated with subsequent development of preeclampsia 8 and gestational diabetes mellitus, 35 other insulin-resistant states.…”

Section: Discussionmentioning

confidence: 99%

Insulin Resistance and Alterations in Angiogenesis

et al. 2004

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Abstract-Altered angiogenesis and insulin resistance, which are intimately related at a molecular level, characterize preeclampsia. To test if an epidemiological interaction exists between these two alterations, we performed a nested case-control study of 28 women who developed preeclampsia and 57 contemporaneous controls. Serum samples at 12 weeks of gestation were measured for sex hormone binding globulin (SHBG; low levels correlate with insulin resistance) and placental growth factor (PlGF; a proangiogenic molecule Key Words: pregnancy Ⅲ insulin resistance Ⅲ preeclampsia Ⅲ clinical trials P reeclampsia is associated with considerable maternal and neonatal morbidity and mortality, and although most agree that preeclampsia is an endothelial cell disorder, the pathogenesis of preeclampsia is not well understood. 1 Recently, preeclampsia has been associated with alterations in expression of angiogenesis-related proteins such that administration of placental soluble fms-like tyrosine kinase 1 (sFlt-1), an endogenous inhibitor to vascular endothelial growth factor (VEGF) and placental growth factor (PlGF), to rats resulted in hypertension, proteinuria, and glomerular endotheliosis, a phenotype with similarities to human preeclampsia. 2 Indeed, low levels of serum PlGF and VEGF (proangiogenic) and increased levels of sFlt-1 (antiangiogenic) appear to antedate the onset of clinical symptoms. [3][4][5][6][7] In addition to alterations in angiogenesis, however, women who develop preeclampsia also have evidence of insulin resistance. 8,9 Large studies suggest women with pregestational diabetes mellitus 10 and women who develop gestational diabetes mellitus 11 have an increased risk for developing preeclampsia. Importantly, recent data from in vitro models outside of pregnancy suggest insulin signaling and angiogenesis are intimately related at a molecular level. 12-14 Because both normal insulin signaling and angiogenesis maintain endothelial cell health, it is plausible that women with pre-existing alterations in insulin metabolism have an exaggerated response to alterations in angiogenic factors, and alterations in both pathways may interact to magnify the risk for preeclampsia. In an effort to identify early pregnancy markers that are biologically linked to the pathogenesis of preeclampsia, we tested the hypothesis that an epidemiological interaction exists between insulin resistance and angiogenesis by measuring markers for both in a prospective nested case-control study.

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“…Two studies reported an inverse association between SHBG and visceral fat tissue. 41,47 In another study, including pre-, peri-and postmenopausal women, high BT and low SHBG levels were also found to be associated with an increase in visceral fat, independently of age, insulin resistance and estradiol. 78 As all studies used a cross-sectional design, the causal direction of the reported associations cannot be ascertained.…”

Section: Cardiovascular Risk Factors and Diseasementioning

confidence: 94%

Testosterone, SHBG and cardiovascular health in postmenopausal women

Brand

Schouw

2010

Int J Impot Res

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Cardiovascular disease (CVD) affects men and women differently with women having a lower incidence and later onset of disease. Research has recently refocused interest on the cardiovascular role of androgens. The purpose of this review is to summarize the evidence available on the association between testosterone and cardiovascular health in postmenopausal women. Published studies relating testosterone and sex hormone-binding globulin (SHBG) to CVD and its risk factors were reviewed. Studies included in this review suggest that increased androgenicity, characterized by high testosterone and low SHBG levels, is associated with an adverse CVD risk factor profile in postmenopausal women. However, evidence for an association with cardiovascular events is lacking and it is uncertain whether the observed associations with endogenous testosterone have clinical implications regarding the use of postmenopausal testosterone therapy. Large-scale, longitudinal studies relating testosterone and SHBG levels to cardiovascular risk factors and endpoints are needed to determine the temporal relationship between androgenicity and cardiovascular risk and to ascertain the long-term efficacy and safety of testosterone therapy in postmenopausal women.

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Relationship between sex hormone-binding globulin levels and features of the metabolic syndrome

Cited by 75 publications

References 36 publications

Sex hormone-binding globulin is a major determinant of the lipid profile: the PRIME study

Sex hormone-binding globulin is a major determinant of the lipid profile: the PRIME study

Insulin Resistance and Alterations in Angiogenesis

Testosterone, SHBG and cardiovascular health in postmenopausal women

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