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目的 探讨伴有和不伴有 2型糖尿病的绝经后妇女性激素结合球蛋白 (SHBG)与胰岛素抵抗的关系。方法 对 60例绝经后妇女 (伴 2型糖尿病组 30例 ,单纯绝经后组 30例 )测定总睾酮 (T)、雌二醇 (E2 )、SHBG、空腹胰岛素 (FINS)、空腹血糖 (FBG)及血脂 ,以1 /FINS×FBG作为胰岛素敏感指数 (ISI) ,并与 2 0例绝经前妇女 (对照组 )进行比较。结果 绝经后组E2 、SHBG均较对照组下降 ,T、FINS则明显升高 (P <0 0 1 ) ,伴 2型糖尿病的绝经后组此差异更为显著 ,并伴血脂异常。多元回归相关分析显示 ,SHBG与T、血清胰岛素呈显著负相关 ,与ISI呈正相关。结论 绝经后妇女 ,特别是伴 2型糖尿病的患者胰岛素抵抗与性激素、SHBG有着密切的关系 ,SHBG水平是预示绝经后妇女发生 2型糖尿病的一个危险因子
Objective To investigate the relationship between insulin resistance and sex hormone binding globulin (SHBG) in postmenopausal women with and without type 2 diabetes mellitus. Methods The total testosterone (T), estradiol (E2), SHBG, fasting insulin (FINS) and fasting blood glucose (FBG) were determined in 60 postmenopausal women (30 with type 2 diabetes mellitus and 30 with simple menopause) And blood lipids, using 1 / FINS × FBG as insulin sensitivity index (ISI), and compared with 20 premenopausal women (control group). Results The levels of E2 and SHBG in postmenopausal group decreased compared with those in control group, and the levels of T and FINS were significantly increased (P <0.01). The difference between menopausal and postmenopausal women with type 2 diabetes was more significant and with dyslipidemia. Multivariate regression analysis showed that SHBG was negatively correlated with T and serum insulin, and positively correlated with ISI. Conclusions Insulin resistance is closely related to sex hormone and SHBG in postmenopausal women, especially those with type 2 diabetes. SHBG level is a risk factor for type 2 diabetes in postmenopausal women