title: Intensive insulin therapy increases sex hormone-binding globulin in newly diagnosed type 2 diabetic patients.
abstract: OBJECTIVE
  Many studies have shown that low sex hormone-binding globulin (SHBG) is associated with insulin resistance, but only few studies have examined how serum SHBG is regulated by insulin in humans. This interventional study aimed to investigate the effect of insulin therapy (IT) on serum SHBG levels in newly diagnosed type 2 diabetic patients.
  
  
  METHODS
  A total of 80 newly diagnosed type 2 diabetic subjects were enrolled and randomly grouped into a 2-week intensive IT with/without metformin. Serum SHBG, total testosterone, glucose, liver enzymes, lipids, insulin, and C-peptide levels were measured before and after IT.
  
  
  RESULTS
  Before IT, serum SHBG levels were negatively correlated with BMI, waist circumference (WC), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (γ-GT), triglyceride (TG), fasting insulin, and C-peptide, and homeostatic model assessment of insulin resistance (HOMA-IR), and positively with HDL-C (all P for trend <0.05), after adjustment for age and sex. IT increased serum SHBG levels from 26.5±14.5 to 33.2±15.0 nmol/l (P<0.001), increased by 25.2% (95% CI, 20.3 to 30.9%, P<0.001). In a multiple linear regression model adjusting for age, sex, BMI, and WC, the decreases in ΔALT (standardized regression coefficient β=-0.374, P=0.012) and ΔTG (β=-0.380, P=0.020) were independent contributors to the increase in ΔSHBG.
  
  
  CONCLUSIONS
  IT increases serum SHBG likely through improving insulin resistance and liver function.
authors.affiliation: Division of Endocrinology, the Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing 210008, China.
authors.forename: Guoyu
authors.initials: G
authors.lastname: Tong
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Hua
authors.forename: Yingjie
authors.initials: Y
authors.lastname: Zhong
authors.forename: Kui
authors.initials: K
authors.lastname: Zhang
authors.forename: Guangyu
authors.initials: G
authors.lastname: Gu
authors.forename: Wenhuan
authors.initials: W
authors.lastname: Feng
authors.forename: Hong
authors.initials: H
authors.lastname: Huang
authors.forename: Weimin
authors.initials: W
authors.lastname: Wang
authors.forename: Lirong
authors.initials: L
authors.lastname: Li
authors.forename: Yanjun
authors.initials: Y
authors.lastname: Sun
authors.forename: Tianyan
authors.initials: T
authors.lastname: Zhang
authors.forename: Yun
authors.initials: Y
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000410:Alanine Transaminase / Q000378:metabolism; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy; D005723:gamma-Glutamyltransferase / Q000378:metabolism; D006706:Homeostasis; D007328:Insulin / Q000008:administration & dosage / Q000097:blood; D007333:Insulin Resistance; D008099:Liver / Q000502:physiology; D008687:Metformin / Q000627:therapeutic use; D008954:Models, Biological; D017698:Postmenopause; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D000410:Alanine Transaminase; D005723:gamma-Glutamyltransferase; D007328:Insulin; D008687:Metformin; D012738:Sex Hormone-Binding Globulin; D014280:Triglycerides