title: Sex hormone-binding globulin levels and cardiovascular risk factors in morbidly obese subjects before and after weight reduction induced by diet or malabsorptive surgery.
abstract: One of the main goals of weight reduction in morbidly obese subjects is its benefit on coronary heart disease (CHD) risk. A cross-sectional study was designed to randomly assign 79 morbidly obese subjects (27 men and 52 women; age: 30-45 years) either to a diet protocol (20 kcal per kg fat-free mass (FFM); 55% carbohydrates, 30% fat, and 15% proteins) or to malabsorptive surgery (biliopancreatic diversion). Fatness parameters, measured by dual-energy X-ray absorptiometry, lipid profile, insulin, leptin, sex steroid hormones and sex hormone-binding globulin (SHBG) levels were compared at baseline and 1 year after the beginning of the study. The data showed that plasma SHBG levels, but not testosterone levels, correlated negatively to fasting insulin levels and positively to HDL-cholesterol in both men and women. Total leptin levels were significantly lower (P<0.0001) in post-BPD subjects of both sexes compared to dietary treated obese subjects. The logarithm of plasma leptin correlated significantly and positively with insulin but negatively with SHBG.A step-down regression analysis showed that FFM and SHBG, but not insulin levels, were the most powerful independent variables for predicting HDL-cholesterol levels in morbidly obese patients. The negative relationship between SHBG levels and CHD risk appears to be mediated by a concomitant variation in body fatness. Finally, in obese patients, SHBG levels seem to be an indicator of total adiposity rather than an index of an altered insulin/glucose homeostasis.
authors.affiliation: Istituto di Medicina Interna, Università Cattolica S. Cuore, Rome, Italy. gmingrone@rm.unicatt.it
authors.forename: G
authors.initials: G
authors.lastname: Mingrone
authors.forename: A V
authors.initials: AV
authors.lastname: Greco
authors.forename: A
authors.initials: A
authors.lastname: Giancaterini
authors.forename: A
authors.initials: A
authors.lastname: Scarfone
authors.forename: M
authors.initials: M
authors.lastname: Castagneto
authors.forename: M
authors.initials: M
authors.lastname: Pugeat
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001823:Body Composition; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000378:metabolism*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018752:Diet, Fat-Restricted; D005260:Female; D015391:Gastroplasty; D006801:Humans; D015994:Incidence; D020738:Leptin / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000178:diet therapy* / Q000453:epidemiology / Q000601:surgery*; D011336:Probability; D012044:Regression Analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D020738:Leptin; D012738:Sex Hormone-Binding Globulin