Studies On The Association Of Serum Sex Hormone-binding Globulin And Macrovascular Complications In Postmenopausal Women With Type 2 Diabetes Mellitus

Objective To investigate the relationship between the changes of serum sex hormones-binding globulin and macrovascular complications in postmenopausal women with type 2 diabetes mellitus(T2DM).Methods Eighty-five subjects were divided into three groups according to menopause and diagnosis criteria of diabetes:Forty-five postmenopausal women with T2DM including twenty patients with macrovascular complications and twenty-five patients without macrovascular complications , twenty postmenopausal women without T2DM,and twenty premenopausal women in the control group. Their weight,height,waist,hip circumferences,blood pressure weremeasured.FastingSHBG,glucose(FBS),insulin(FINS),c-eptide(FCP),lipid,fibrinogen(FIB)were determined. ISI=-Ln(FBS*FINS) was used as insulin sensitivity indexes. Result The postmenopausal women without T2DM showed significantly lower SHBG and lower ISI as compared with the control group(P<0.05),and showed significantly higher SHBG and higher ISI as compared with the postmenopausal women with T2DM (P<0.01). In postmenopausal women with T2DM, BMI,WHR,FINS,FCP,TG,LDL-C were significantly higher than those in the the control group,and the postmenopausal women without T2DM showed significantly higher WHR as compared with the control group(P<0.05) and showed significantly lower WHR as compared with the postmenopausal women with T2DM(P<0.05) . In the diabeticmacrovascular complications group, SHBG ,ISI were significantly lower than those in the group without macrovascular complications,and WHR,FBS,FINS,FCP , TC,LDL-C,Fib were significantly higher than those in the group without macrovascular complications. In the simple correlation , the SHBG was significantly negatively correlated with WHR(r=-0.511 p<0.001),and significantly negatively with FBS(r=-0.396 p<0.01),and significantly negatively with FINS(r=-0.636 p<0.001),and significantly negatively with FCP(r=-0.735 P<0.001),and significantly positively with ISI(r=0.731 p<0.001),and with significantly negatively Fib(r=-0.583 p<0.001). In the stepwise regression , FCP,ISI,TC,HDL-C were entered the equation and FCP was the strongest predictor of SHBG. Conclusion Lower SHBG is the marker on insulin sensitivity and is the risk factor of macrovascular complications in postmenopausal women with type 2 diabetes mellitus.