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目的了解血清性激素结合球蛋白(SHBG)与2型糖尿病患者大血管病变的相关性。方法 2011年6月~2012年5月在新疆维吾尔自治区人民医院内分泌科纳入2型糖尿病患者78例,分为两组:一组为合并大血管病变组,39例;另一组为无大血管病变组,39例。采用化学发光法测定2型糖尿病患者血清性激素结合球蛋白(SHBG)、空腹胰岛素(FINS)、空腹血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、脂蛋白α(Lp-α),采用高效色谱法测定血浆糖化血红蛋白(HbA1c),以ISI作为胰岛素敏感指数。采用SPSS统计软件进行数据统计及处理,正态分布计量资料用(x±s)表示,组间生化指标比较采用t检验。结果合并大血管病变组血清SHBG水平明显低于无大血管病变组(P<0.05)。2型糖尿病合并大血管病变患者,血清SHBG与其它指标的相关性分析显示,与FINS、FBG、HDL-C呈负相关(r=-0.046、-0.159、-0.056);与ISI、HBc、TC、TG、LDL-C、Lp-α呈正相关(r=0.061、0.076、0.184、0.184、0.111、0.010)。多元素逐步回归分析,SHBG对糖尿病合并大血管病变有预测价值。结论血清SHBG含量的降低,可能是2型糖尿病大血管病变发生发展的危险因素之一。
Objective To investigate the correlation between serum sex hormone binding globulin (SHBG) and macrovascular complications in type 2 diabetic patients. Methods From June 2011 to May 2012, 78 patients with type 2 diabetes mellitus were included in the Department of Endocrinology of People’s Hospital of Xinjiang Uygur Autonomous Region from June 2011 to May 2012. The patients were divided into two groups: one group with macrovascular complications group (n = 39); the other group without macrovascular Lesion group, 39 cases. The serum levels of sex hormone binding globulin (SHBG), fasting insulin (FINS), fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG) and high density lipoprotein (HDL- C, LDL-C and Lp-α. Plasma HbA1c was measured by high performance liquid chromatography (HPLC) and ISI was used as insulin sensitivity index. SPSS statistical software was used for data statistics and processing. The normal distribution measurement data were expressed as (x ± s). The biochemical indexes of the groups were compared by t-test. Results Serum SHBG levels in patients with macrovascular complications were significantly lower than those without macrovascular complications (P <0.05). In patients with type 2 diabetes mellitus and macroangiopathy, the correlation between serum SHBG and other indicators showed a negative correlation with FINS, FBG and HDL-C (r = -0.046, -0.159, -0.056) , TG, LDL-C and Lp-α (r = 0.061,0.076,0.184,0.184,0.111,0.010). Multi-element regression analysis showed that SHBG had predictive value for diabetic macroangiopathy. Conclusion The decrease of serum SHBG may be one of the risk factors for the development of macroangiopathy in type 2 diabetic patients.