Association of decreased sex hormone binding globulin and cardiovascular risk factors.

Abstract

Sex hormones play a major role in determining the risk of cardiovascular disease. While earlier studies have shown that reduced sex hormone binding globulin (SHBG) Is associated with increased glucose and Insulin concentrations in premenopausal women, few data exist on the relationship of SHBG to other cardiovascular risk factors in women. We hypothesized that decreased SHBG would be associated with an atherogenlc pattern of cardiovascular risk factors. We measured total testosterone, total estradlol and SHBG, llplds and lipoproteins, glucose and insulin, and systolic and dlastolic blood pressure In 96 premenopausal women. Although total testosterone and total estradiol were not related to cardiovascular risk factors, SHBG was negatively associated with trlglycerlde concentration (r=-0.37) and positively associated with high density llpoproteln cholesterol (HDLC) (r=0.42). After adjustment for overall adiposity (body mass index) and upper body adiposity (as measured by the ratio of waist-to-hlp circumferences), SHBG was still positively related to HDLC, but not to trlglycerlde. Adjustment for Insulin abolished the relationship between SHBG and triglyceride levels, but did not alter the relationship between SHBG and HDLC. Sex hormones were not related to either systolic or dlastolic blood pressure. (Arteriosclerosis 9:136-143, January/February 1989) S ex hormones play a major role in determining the risk of cardiovascular disease. Indirect evidence for this concept is provided by the higher triglyceride and low density lipoprotein cholesterol (LDLC) and lower high density lipoprotein cholesterol (HDLC) levels in men than in women.1 More direct evidence for the role of sex hormones as determinants of cardiovascular risk factors is provided by studies showing that exogenous androgen administration increases LDLC and decreases HDLC. 23 Conversely, administration of estrogens to postmenopausal women with familial hypercholesterolemia is associated with decreased LDLC and increased HDLC. 4 Sex hormone binding globulin (SHBG) may also be an important predictor of lipids and lipoproteins, since it is the major determinant of the ratio of free to bound plasma testosterone and other androgens. 5 Although decreased SHBG and increased percent free testosterone have been associated with increased glycemia and insulinemia in premenopausal women, 67 few data exist on the relationship of endogenous sex hormones and SHBG to lipids and lipoproteins. Studies to date suggest that SHBG is positively associated with HDLC in both premenopausal 8 and postmenopausal 9 women.

Anthropometric, computed tomography and fat cell data in an obese population: relationship with insulin, leptin, tumor necrosis factor-alpha, sex hormone-binding globulin and sex hormones

“…These results were in contrast to other studies describing a negative correlation between SHBG and adiposity (50,51). Abdominal fat was signi®cantly lower in the female population, and in premenopausal women (Table 1), and SHBG in the total population was negatively correlated with abdominal fat, especially with visceral fat.…”

Androgenic sex steroids contribute to metabolic risk beyond intra‐abdominal fat in overweight/obese black and white women

“…In contrast to others (13,36), our results demonstrated the added value of examining TT in relation to metabolic variables associated with CVD risk and one that is independent of VAT. This was particularly…”

Plasma lipoproteins and the incidence of abnormal excretion of albumin in diabetic American Indians: The Strong Heart Study

“…Women have higher HDL cholesterol than men and sex hormones could affect several enzymes involved in lipid metabolism [44]. A low HDL cholesterol could then be a reflection of sex hormone activity in that a low HDL cholesterol is associated with a lower concentration of sex hormone binding globulin in women [45] and a high concentration in men [46]. The fact that the relation between HDL cholesterol and diabetic nephropathy might be stronger among pre±menopausal women or women taking estrogen than among post±menopausal women favours this hypothesis but development of menopause during follow-up could be responsible for some confounding.…”