Association of sex hormone-binding globulin and free testosterone with mortality in men with type 2 diabetes mellitus.
نویسندگان
چکیده
OBJECTIVE Low circulating testosterone levels have been associated with increased mortality in men. We hypothesized that the prognostic role of testosterone in men with type 2 diabetes mellitus (T2DM) is influenced by its carrier protein sex hormone-binding globulin (SHBG). DESIGN We conducted a prospective cohort study at a tertiary referral centre. METHODS In total, 531 men with T2DM presenting to a diabetes clinic in 2004-2005 were followed prospectively until death, or July 31, 2014, and a survival analysis was performed. The main outcome measure was all cause mortality. RESULTS Over a mean (S.D.) follow up of 7.6 years (2.6) 175 men (33%) died. In Cox proportional hazard models both higher SHBG (Hazard Ratio (HR) 1.012 (95% CI 1.002-1.022), P=0.02) and lower calculated free testosterone (cFT) (HR 0.995 (95% CI 0.993-0.998), P=0.001) were risk factors for all cause mortality independently of age, BMI, presence of macro- and microvascular disease, duration of T2DM, hemoglobin, renal function, insulin use, C-reactive protein and homeostatic model of insulin resistance. By contrast, the inverse association of total testosterone (TT) with mortality weakened after these adjustments (P=0.11). SHBG remained associated with mortality (P<0.001) both if substituted for or added to TT in the multivariable model. In the fully adjusted model, an increase of SHBG by 17.3 nmol/l (1 S.D.) increased mortality by 22% and a decrease in cFT by 81 pmol/l (1 S.D.) increased mortality by 45%. CONCLUSIONS The association of SHBG with mortality in men with T2DM is novel. Whether SHBG acts via regulation of testosterone, has intrinsic biological roles, or is a marker of poor health requires further study.
منابع مشابه
The Evaluation of Serum Level of Testosterone and Sex Hormone- Binding Globulin in Men with Type 2 Diabetes
OBJECTIVE: To evaluate the relationship between serum level of testosterone and sex hormone-binding globulin in men with type 2 diabetes. MATERIALS AND METHODS: In this case-control study, forty men aged 40-70 with type 2 diabetes mellitus were randomly selected and compared with 40 non-diabetic men. The two groups were matched for their age and BMI. After complete observation and examination...
متن کاملبررسی ارتباط بین سطح سرمی تستوسترون با دیابت نوع 2
Background : Diabetes mellitus is a common metabolic disease. Its association with low level of testosterone has already been shown in many studies. Considering the role of testosterone hormone in impotency, fatigue, and bone mass deficiency this study aimed to investigate the association between serum total testosterone, free testosterone index (FTI), and sex hormone-binding globulin (SHBG) ...
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OBJECTIVE The aim of our study was to assess the prevalence of clinical hypogonadism, based on both symptoms and biochemical available measures of testosterone deficiency, in men with type 2 diabetes. RESEARCH DESIGN AND METHODS In a cross-sectional study of 355 type 2 diabetic men aged >30 years, total and bioavailable testosterone, sex hormone-binding globulin, BMI, and waist circumference ...
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OBJECTIVE To assess associations of sex hormones with impaired fasting glucose (IFG) and type 2 diabetes in men. RESEARCH DESIGN AND METHODS A total of 3,156 African American, Non-Hispanic white, Hispanic, and Chinese-American men aged 45-84 years who participated in the baseline visit of the Multi-Ethnic Study of Atherosclerosis (MESA) were included. Odd sratios and 95% CIs for type 2 diabet...
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ورودعنوان ژورنال:
- European journal of endocrinology
دوره 174 1 شماره
صفحات -
تاریخ انتشار 2016