·胰岛素抵抗及其相关疾病·

　　【摘要】 目的 观察中青年男性新诊断糖尿病患者性激素结合蛋白(SHBG)的变化，探讨其与IR及胰岛早相分泌功能的关系。 方法 纳入新诊断男性糖尿病患者56例，另选健康中青年男性38名，测定SHBG，进行精氨酸试验。 结果 两组SHBG、胰岛素抵抗指数(HOMA-IR)差异有统计学意义(P<0.01)。相关分析显示，SHBG与HOMA-IR呈负相关(r=-0.219,P<0.05)。Logistic回归分析显示，SHBG是胰岛素抵抗的唯一有效自变量(偏回归系数为-0.75, P<0.05,OR=0.47)。二元Logistic回归分析得出HOMA-IR是糖尿病的危险因素，SHBG是糖尿病的保护因素。胰岛2 min分泌高峰值与HOMA-IR呈正相关(标准回归系数为0.567，P<0.05)。 结论 中青年男性新诊断糖尿病患者存在血清SHBG降低，SHBG与HOMA-IR呈负相关，是新诊断中青年男性糖尿病患者的独立保护因素。胰岛β细胞第一时相分泌功能减退与IR有相关性，与SHBG无相关性。

　　【关键词】 性激素结合球蛋白;糖尿病;胰岛素抵抗;中青年

Investigation the changes and its significance of sex hormone-binding globulin in newly diagnosed young-middle age male diabetic patients WANG Chong，WANG Yan-gang，WANG Luan，et al . Department of Endocrinology, Affiliated Hospital Of Qingdao University Medical College, Shandong 266003, China

　　【Abstract】 Objective To observe the changes of sex hormone-binding globulin (SHBG) in newly diagnosed young-middle age male diabetic patients, and to explore the relationship between SHBG and insulin resistance (IR) and first phase secretion of β-cell. Methods Fifty-six young-middle age male patients with newly diagnosed diabetes. Another 38 male cases were enrolled as control group, SHBG and concurrent L-arginine stimulation test were all detected in two groups. Results The levels of SHBG and HOMA-IR were significantly different between the two groups(P<0.01). SHBG has negative correlation with HOMA-IR(r=-0.219, P<0.05). Logistic regression analysis showed insulin resistance was the only valid factor for SHBG (partial regression coefficient=-0.75, P<0.05, OR=0.47). Binary Logistic regression analysis showed that HOMA-IR was a risk factor for diabetes, and SHBG was a protective factor for diabetic patients. Both SHBG and control groups reached a peak in 2 min, the insulin secretion peak has positively correlated with HOMA-IR (standardized regression coefficients were 0.567, P<0.05). Conclusion The newly diagnosed young-middle age male diabetes have insulin resistance. Compared with the control group, the levels of SHBG was significantly lower in SHBG group. SHBG is not only a predict factor for insulin resistance, but also the independent protective factor in newly diagnosed young-middle age male diabetes. Islet β cells in the first phase secretion dysfunction associated with insulin resistance, but no correlation with SHBG.

　　【Key words】 Sex hormone-binding globulin; Insulin resistance; Diabetes; Young-middle age, male