The Biological Variation of Sex Hormone-Binding Globulin in Type 2 Diabetes
Implications for sex hormone-binding globulin as a surrogate marker of insulin resistance
- Vijay Jayagopal, MRCP1,
- Eric S. Kilpatrick, MRCPATH2,
- Paul E. Jennings, FRCP3,
- Steve Holding, PHD2,
- David A. Hepburn, FRCP1 and
- Stephen L. Atkin, FRCP1
- 1Department of Medicine, University of Hull, Hull, U.K.
- 2Department of Clinical Biochemistry, Hull Royal Infirmary, Hull, U.K.
- 3Department of Medicine, York Hospital, York, U.K.
- Address correspondence to Dr. V. Jayagopal, Michael White Centre for Diabetes and Endocrinology, Brocklehurst Building, Hull Royal Infirmary, 220-236 Anlaby Road, Hull, HU3 2RW, U.K. E-mail:
Quantitative determination of insulin resistance is technically demanding and expensive. We have recently shown (1) that insulin resistance determined using the homeostasis model assessment of insulin resistance (HOMA-IR) has a significantly greater biological variability in individuals with type 2 diabetes than in healthy ones. A surrogate marker of insulin resistance that was reproducible, stable, and easily measured would be invaluable for both research and clinical practice, particularly for following insulin-sensitizing therapy, such as metformin and the thiazolidinediones. A low sex hormone-binding globulin (SHBG) concentration reflects hyperinsulinemic insulin resistance and has been proposed as such a surrogate measure (2–4). This study aimed to compare the biological variation of SHBG and insulin resistance in type 2 diabetes to determine the potential for SHBG as a surrogate marker of insulin resistance in type 2 diabetes.
Subjects were initially recruited for a study to assess the biological variation of insulin resistance in individuals with type 2 diabetes (1). Postmenopausal Caucasian subjects (n = 12) with type 2 diabetes (median age 62 years, range 50–73, and median BMI 31.6 kg/m2, range 25.1–35.7) and 11 age- and weight-matched, healthy, postmenopausal Caucasian control subjects …