Serum sex hormone binding globulin profile and its association with insulin resistance in Chinese peri-menopausal women.

INTRODUCTION The aim of this study was to measure serum sex hormone binding globulin (SHBG) profile in Chinese peri-menopausal women, and assess its correlation with insulin resistance (IR)-related parameter, namely HOMA-IR, in this special population. MATERIAL AND METHODS A cross-sectional study by the method of cluster sampling was performed in 1,827 women, who were in hospital for routine check-up. Serum SHBG profile and anthropometric indices of hormonal, adiposity, and metabolic variables were measured. According to their age and menstruation status, the subjects were divided into three groups: pre-menopause group, peri-menopause group, and post-menopause group. RESULTS Serum SHBG level was found to be negatively correlated with BMI in all groups and to increase in parallel with age in women of reproductive age. However, independently of age, it significantly increased from the onset of menopause transition, and slightly declined after menopause. After adjustment for age and BMI, HOMA-IR in peri-menopausal women was closely related only to SHBG. SHBG level was found to be the only independent significant determinant of HOMA-IR. On the basis of ROC curve analysis for the prediction of insulin resistance using HOMA-IR value, AUC for SHBG reached a value of 0.816 (0.636-0.996, 95% confidence interval). The best cutoff value that discriminates peri-menopausal women with or without insulin resistance is 41.73 nmol/L, with a sensitivity of 81.4% and a specificity of 87.5%. CONCLUSIONS Low SHBG level may be an independent risk factor of insulin resistance in Chinese peri-menopausal women.