摘要
目的研究绝经后妇女的性激素结合球蛋白与冠心病及胰岛素抵抗的关系。方法将89例受试者按照WHO诊断标准分为2组,57例冠心病组及32例无冠心病组。放免法测定性激素结合球蛋白,并常规检测空腹血糖、胰岛素、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、纤维蛋白原。以ISI作为胰岛素敏感性指标。结果冠心病组性激素结合球蛋白、高密度脂蛋白胆固醇和胰岛素敏感指数显著低于单纯绝经后组(P<0.01)。而胰岛素、甘油三酯、低密度脂蛋白胆固醇、纤维蛋白原显著高于绝经后无冠心病组。相关分析显示性激素结合球蛋白与低密度脂蛋白胆固醇、胰岛素及甘油三酯呈显著负相关(r=-0.320、-0.451、-0.131,P<0.01),而与胰岛素敏感指数呈显著正相关(r=0.231,P<0.001)。多元Logistic回归分析显示血清性激素结合球蛋白与冠心病的发生独立负相关。结论低的血清性激素结合球蛋白是胰岛素抵抗的标志,对血脂代谢具有不利影响,是绝经后妇女合并冠心病的独立危险因素。
Objective To investigate the relation of serum levels of sex hormone binding globulin （SHBG） to coronary heart disease （OHD） and insulin resistance in postmenopausal women. Methods Eighty- nine postmenopausal women were divided into the CHD group （n= .57） and the group without CHD （n= 32） according to WHO diagnosis criteria of coronary heart disease. SHBG was analyzed by the radio- immunity method. Glucose （FBS）, insulin （FINS）, triglyceride （TG）, high density lipoprotein- cholesterol （HDL- C）, low density lipoprotein - cholesterol （LDL - C） and fibrinogen （FIB） were routinely examined. ISI was used as insulin sensitivity index. Results The postrnenopausal women with CHD showed significantly lower SHBG, HDL-C, and ISI as compared with the menopause women without CHD （P〈0.01）, while the women with CHD had significantly higher FINS, TG, LDL - C, and FIB. The simple correlation showed that SHBG was significantly negatively correlated with LDL- C （r = - 0. 320, P〈 0.01）, FINS （r = - 0. 451, P〈0.01）, and TG （r = - 0. 131, P〈 0.01）, but significantly positively correlated with ISI （r = 0. 231, P 〈 0. 001）. By multivariate logistic regression analysis, SHBG was independently negatively correlated with CHD. Conclusions Lower SHBG is the marker of insulin resistance and the independent risk factor of CHD in postmenopausal women, for which can bring unfavorable impact on lipids metabolism.
出处
《实用预防医学》
CAS
2010年第1期88-90,共3页
Practical Preventive Medicine
关键词
绝经
冠心病
性激素结合球蛋白
胰岛素抵抗
Menopause
Coronary heart Disease
Sex hormone- binding globulin
Insulin resistance
