Sex hormone binding globulin - an important biomarker for predicting PCOS risk: A systematic review and meta-analysis

Abstract

Sex hormone-binding globulin (SHBG) is a glycoprotein which regulates bioavailability of sex steroid hormones. Interest in SHBG has escalated in recent years because of its inverse association with polycystic ovary syndrome (PCOS), obesity, insulin resistance, metabolic syndrome, and diabetes type II. This meta-analysis was performed to examine the associations of SHBG with PCOS and to correlate serum SHBG levels with various PCOS associated endocrine and metabolic dysregulation as well as to determine the effects of various therapeutic agents on serum SHBG levels in PCOS patients in order to assess the true accuracy of SHBG in the prediction of PCOS. A literature search was performed using Pub-Med, Science direct, google scholar, EMBASE, and Cochrane library. A total of 675 relevant records were identified, of which 62 articles were included. Meta-analysis using a random-effects model was performed using STATA version 13 to calculate standardized mean difference (SMD) with 95% confidence intervals (95 % CIs). SHBG levels in controls were significantly higher than that of PCOS patients (SMD= -0.83, 95%CI = -1.01, -0.64), with significant heterogeneity across studies (I= 93.9% and p=0.000). Our results suggest that the lower serum SHBG levels are associated with the risk of PCOS. SHBG may also play an important role in various metabolic disturbances in PCOS patients. Therapeutic interventions improved SHBG levels in PCOS women which further reduced PCOS associated complications. Therefore, SHBG levels may prove to be a useful biomarker for the diagnosis and treatment of PCOS. Systematic review registration: PROSPERO CRD42017057972 Abbreviations: PCOS: polycystic ovary syndrome; SHBG: sex hormone-binding globulin.

Micronutrients in support to the one carbon cycle for the modulation of blood fasting homocysteine in PCOS women

“…Circulating SHBGs are consistently decreased in PCOS contributing to the increased FTI [28] and the decrease correlates with insulin resistance [29]. The baseline Hcy values of our patients correlated negatively with the concentration of SHBG, which is a new finding of this study.…”

“…A total of 33 PCOS ladies (mean age 26.8, range [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] were enrolled between June 2017 and October 2018, and one patient withdrew her participation for personal reasons after the basal visit. Out of 32 patients randomized, 22 entered the active treatment group, and 10 the no treatment group.…”

Polycystic Ovary Syndrome as a systemic disease with multiple molecular pathways: a narrative review

“…In PCOS women, the serum levels of sex hormone binding globulin (SHBG) tend to be decreased, which contributes to an increase in free testosterone (Nestler et al 1991;Fan et al 2013;Azziz et al 2016;Deswal et al 2018), the biologically active form of the hormone (Burtis et al 2008). This is believed to happen because insulin inhibits SHBG production by hepatocytes, a mechanism that may be exacerbated in women with PCOS due to hyperinsulinemia (Nestler et al 1991;Bartha et al 2000;Azziz et al 2016).…”

“…Moreover, higher levels of SHBG were associated with lower BMI, abdominal circumference, waist to hip ratio, leptin levels and adiposity (visceral and subcutaneous adipose tissue measured by magnetic resonance imaging). Deswal et al (2018) have analyzed 10 studies about the effects of therapeutic interventions (with inositol, metformin, oral contraceptives, rosiglitazone, omega 3 or arcabose) on SHBG levels in women with PCOS, and have observed that the increase of SHBG levels is associated to an improvement in endocrine and metabolic parameters in these women.…”

Ефективність Використання Вітаміну D У Комплексному Лікуванні Безпліддя У Жінок Із Синдромом Полікістозних Яєчників

“…Ці порушення спричиняють виникнення гормонального дисбалансу, що сприяє підвищенню концентрації андрогенів над естрогенами. Як відомо, для більшості жінок із СПКЯ характерна інсулінорезистентність, в результаті чого виникає компенсаторна гіперінсулінемія, яка сприяє підвищеному виробленню андрогенів в яєчниках та надниркових залозах, що підвищує біодоступність андрогенів за рахунок зниження концентрації глобуліну, що зв'язує статеві гормони [19][20][21][22]. Важливе місце в патогенезі СПКЯ відіграє ожиріння, при якому порушується толерантність до глюкози за діабетичним типом, розвиваються інсулінорезистентність та компенсаторна гіперінсулінемія.…”