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Sex Hormone Binding Globulin and Testosterone in Individuals with Childhood Diabetes

¹Institute for Endocrine Discovery and Clinical Care, University of Chicago
²Department of Health Studies, University of Chicago

kdaniels{at}peds.bsd.uchicago.edu

ABSTRACT

Objective: Insulin down-regulates hepatic production of sex hormone binding globulin (SHBG), which in turn influences sex hormone bioavailability. The effects of childhood-onset diabetes, and of insulin resistance in nondiabetics, on SHBG and testosterone in children and young adults are poorly understood.

Research Design and Methods: Individuals with diabetes diagnosed <18 years of age (n=48) and their siblings without diabetes (n=47) were recruited for the Chicago Childhood Diabetes Registry Family Study. SHBG and total and free testosterone were measured. Participants ranged in age from 10-32 years; 39% were Non-Hispanic white. The majority of individuals with diabetes was classical type 1 phenotype (75%), while the remainder exhibited features of type 2 or mixed diabetes; 96% were treated with insulin.

Results: SHBG and total testosterone were higher in males with diabetes compared to male siblings. Elevated SHBG was associated with the absence of endogenous insulin independent of gender; elevated total testosterone was similarly associated with the absence of C-peptide but only for males. Diabetes type and treatment were unrelated. In those without diabetes, greater insulin resistance had a small, nonsignificant association with lower SHBG and higher free testosterone.

Conclusions: SHBG and total testosterone appear to be higher in male children and young adults with diabetes compared to nondiabetic male siblings, apparently related to the absence of endogenous insulin. This may have implications for sex hormone-dependent processes across the lifespan in males diagnosed with diabetes as children.

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