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Low serum sex hormone‐binding globulin is associated with nonalcoholic fatty liver disease in type 2 diabetic patients
Author(s) -
Hua Xiaomin,
Sun Yanjun,
Zhong Yingjie,
Feng Wenhuan,
Huang Hong,
Wang Weimin,
Zhang Tianyan,
Hu Yun
Publication year - 2014
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12360
Subject(s) - sex hormone binding globulin , medicine , endocrinology , nonalcoholic fatty liver disease , testosterone (patch) , fatty liver , odds ratio , quartile , diabetes mellitus , body mass index , globulin , insulin resistance , hormone , confidence interval , androgen , disease
Summary Introduction Studies have indicated that low serum sex hormone‐binding globulin ( SHBG ) and testosterone levels are associated with nonalcoholic fatty liver disease ( NAFLD ). However, it remains unclear whether an association exists between SHBG and NAFLD independent of testosterone. Objective This study was aimed to investigate the relationship between SHBG and both total and free testosterone levels with NAFLD . Subjects and Measures One hundred and twenty patients with NAFLD and 120 age‐, sex‐ and BMI ‐matched patients with non‐ NAFLD were enrolled into a case–control study. Serums SHBG , total testosterone ( TT ), liver enzymes, lipids, insulin, C ‐peptide and plasma glucose were measured. Free testosterone ( FT ) and fatty liver index were calculated. Results Serum SHBG levels were significantly lower in NAFLD group than in non‐ NAFLD group (24·5 ± 11·0 vs 37·6 ± 14·4 n m , P < 0·001). After adjustment for age, smoking status, alcohol use, duration of diabetes, BMI and fasting C ‐peptide, serum SHBG levels in men and women were inversely associated with NAFLD , with odds ratio ( OR ) and 95% confidence interval ( CI ) in the forth quartile as 0·05 (0·01–0·30) and 0·25 (0·08–0·77) compared with the first quartile ( OR = 1·00). Additional adjustment for TT in men and FT in women did not materially alter the association. The relationship between serum TT (for men) and FT (for women) with NAFLD was attenuated and even diminished after multivariable adjustment for known risk factors and SHBG . Conclusion Low serum SHBG levels, but not TT or FT , are associated with NAFLD in type 2 diabetic patients.