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目的探讨血清性激素结合球蛋白(SHBG)与代谢综合征(MS)发生之间的相关性。方法收集2011年1月至2013年12月在本院接受体检者398例,根据是否合并MS分为MS组和非MS组,比较两组的临床特征及血清性激素结合球蛋白水平。结果 MS组的SHBG水平为(19±15)nmol/L,显著低于非MS组的(35±34)nmol/L),差异有统计学意义(P<0.05);SHBG与甘油三酯(TG)、胰岛素抵抗指数(HOMA-IR)、空腹胰岛素(FIN)、空腹血糖(FBG)以及舒张压(DBP)呈显著负相关性,而与高密度脂蛋白胆固醇(HDL-C)呈显著正相关性,差异有统计学意义(P<0.05);Logistic回归分析显示,校正性别、年龄、腰臀比、体重指数(BMI)及HOMA-IR后,男性及女性的SHBG与MS的发生风险呈显著负相关(男:OR=0.897,95%CI 0.875~0.919,P<0.05;女:OR=0.985 CI 0.930~1.040,P<0.05)。根据SHBG三分位数从低到高将患者分为A、B、C 3组,A组患病率为70.0%(84/120),B组为51.1%(70/137),C组为24.1%(34/141),差异有统计学意义(P<0.05),可见随着SHBG水平的升高,MS的患病率逐渐下降。结论无论是男性还是女性中,SHBG降低与MS的发生及发展具有密切关系,且随着SHBG水平降低,MS发病率逐渐上升。
Objective To investigate the correlation between serum sex hormone binding globulin (SHBG) and the occurrence of metabolic syndrome (MS). Methods A total of 398 medical examinations were collected from January 2011 to December 2013 in our hospital. According to whether the combined MS was divided into MS group and non-MS group, the clinical characteristics and serum sex hormone binding globulin were compared between the two groups. Results The level of SHBG in MS group was (19 ± 15) nmol / L, which was significantly lower than that in non-MS group (35 ± 34 nmol / L) (P <0.05) TG, HOMA-IR, FIN, FBG and DBP, but negatively correlated with HDL-C Logistic regression analysis showed that the incidence of SHBG and MS in male and female was positively correlated with gender, age, waist-hip ratio, body mass index (BMI) and HOMA-IR (Male: OR = 0.897, 95% CI 0.875-0.919, P <0.05; female: OR = 0.985 CI 0.930-1.040, P <0.05). The patients were divided into A, B and C groups according to the SHBG tertile from low to high. The prevalence of group A was 70.0% (84/120), group B was 51.1% (70/137), group C was 24.1% (34/141), the difference was statistically significant (P <0.05), showing that with the SHBG level increased, the prevalence of MS decreased gradually. Conclusions SHBG reduction is closely related to the occurrence and development of MS in both men and women. The incidence of MS gradually increases with the decrease of SHBG level.