Longitudinal Changes in Sex Hormone Binding Globulin (SHBG) and Risk of Incident Diabetes: The Study of Women's Health Across the Nation (SWAN).

Autor:	Hedderson MM; Division of Research, Kaiser Permanente Northern California, Oakland, CA., Capra A; Division of Research, Kaiser Permanente Northern California, Oakland, CA., Lee C; Division of Research, Kaiser Permanente Northern California, Oakland, CA., Habel LA; Division of Research, Kaiser Permanente Northern California, Oakland, CA., Lee J; Stanford University, Stanford, CA., Gold EB; University of California Davis, Davis, CA., Badon SE; Division of Research, Kaiser Permanente Northern California, Oakland, CA., Mitro SD; Division of Research, Kaiser Permanente Northern California, Oakland, CA., El Khoudary SR; University of Pittsburgh, Pittsburgh, PA.
Jazyk:	angličtina
Zdroj:	Diabetes care [Diabetes Care] 2024 Apr 01; Vol. 47 (4), pp. 676-682.
DOI:	10.2337/dc23-1630
Abstrakt:	Objective: To investigate the associations of longitudinal changes in sex hormone binding globulin (SHBG) and testosterone (T) over the menopause transition with the risk of diabetes. Research Design and Methods: We followed 2,952 participants in the Study of Women's Health Across the Nation (SWAN) who were premenopausal or early perimenopausal and diabetes-free at baseline. SHBG,T, and estradiol (E2) levels were measured at up to 13 follow-up visits (over up to 17 years). We used complementary log-log-based discrete-time survival models anchored at baseline. Results: Diabetes developed in 376 women. A 5-unit increase in time-varying SHBG was associated with a 10% reduced risk of diabetes (hazard ratio [HR] 0.91, 95% CI 0.87-0.95), adjusting for covariates, and baseline SHBG,T, and E2 levels. Time-varying T was not associated with diabetes risk. Compared with the lowest quartile for annual rate of change of SHBG since baseline (quartile 1 [Q1] -92.3 to -1.5 nmol/L), all other quartiles were associated with a decreased risk of diabetes adjusting for covariates and baseline SHBG; associations persisted after adjusting for rate of change of T and E2 (Q2 [> -1.5 to -0.2 nmol/L] HR 0.33, 95% CI 0.23-0.48; Q3 [> -0.2 to 1.3 nmol/L] HR 0.37, 95% CI 0.25-0.55; Q4 [>1.3 to 82.0 nmol/L] HR 0.43, 95% CI 0.30-0.63). Conclusions: Increasing levels of SHBG over the menopause transition were associated with a decreased risk of incident diabetes. Stable to increasing rates of change in SHBG were also independently associated with a decreased risk of diabetes compared with decreasing rates of change, suggesting SHBG may affect glucose through a mechanism beyond androgenicity. (© 2024 by the American Diabetes Association.)
Databáze:	MEDLINE
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