title: Associations of fatty liver disease and other factors affecting serum SHBG concentrations: a population based study on 1657 subjects.
abstract: Sex hormone binding globulin (SHBG) is a glycoprotein expressed predominantly in the hepatocytes. It regulates the transport of sex steroid hormones in the blood stream to their target tissues. The expression of the SHBG gene is subject to multifactorial regulation including hormonal, metabolic, and nutritional aspects. Against this background, we investigated the effect of fatty liver and metabolic syndrome, together with other parameters, on serum SHBG concentrations in a population-based cohort in Germany. This cross-sectional study included 870 women and 787 men (average age 42.3±12.8 years), who underwent ultrasound screening for fatty liver in addition to providing a complete medical history and undergoing physical and laboratory examination. Fatty liver was diagnosed on ultrasound criteria in 159 women (18.3%) and 287 men (36.5%). Fatty liver was shown to exert a significant influence on serum SHBG concentrations in men and in premenopausal women. Men with grade 1 fatty liver had a 1.96-fold increased risk (95%-confidence interval=1.28-3.02; p=0.0022) and postmenopausal women with grade 1 fatty liver a 2.4-fold risk (95%-confidence interval=1.11-5.27; p=0.0267) for low SHBG concentrations. Among metabolic parameters, HDL-C represented as affecting factor in men (p=0.0058) and premenopausal women (p=0.0002), while cholesterol only showed an association in premenopausal women (p=0.0439) and triglyceride in postmenopausal women (p=0.0436). No association of concentrations of SHBG and metabolic syndrome was observed. Age, BMI and waist-to-hip ratio also influence the SHBG concentration. Based on these findings, we conclude that fat accumulation in the liver influences SHBG concentrations in men and premenopausal women.
authors.affiliation: Institute of Epidemiology and Medical Biometry, Ulm, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Flechtner-Mors
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Schick
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Oeztuerk
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany.
authors.forename: M M
authors.initials: MM
authors.lastname: Haenle
authors.affiliation: Department of Mathematics, Natural Sciences and Economic Sciences (Biostatisitcs), University of Applied Sciences Ulm, Ulm, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Wilhelm
authors.affiliation: Department of Internal Medicine II, University Hospital Ulm, Ulm, -Germany.
authors.forename: W
authors.initials: W
authors.lastname: Koenig
authors.affiliation: Department of Internal Medicine II, University Hospital Ulm, Ulm, -Germany.
authors.forename: A
authors.initials: A
authors.lastname: Imhof
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany.
authors.forename: B O
authors.initials: BO
authors.lastname: Boehm
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Medical Center Ulm, Ulm, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Graeter
authors.affiliation: Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Ohio, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Mason
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Kratzer
authors.affiliation: Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany.
authors.forename: A S
authors.initials: AS
authors.lastname: Akinli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005234:Fatty Liver / Q000097:blood*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017697:Premenopause / Q000097:blood; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D055815:Young Adult
chemical_list: D012738:Sex Hormone-Binding Globulin