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

  1. Vijay Jayagopal, MRCP1,
  2. Eric S. Kilpatrick, MRCPATH2,
  3. Paul E. Jennings, FRCP3,
  4. Steve Holding, PHD2,
  5. David A. Hepburn, FRCP1 and
  6. Stephen L. Atkin, FRCP1
  1. 1Department of Medicine, University of Hull, Hull, U.K.
  2. 2Department of Clinical Biochemistry, Hull Royal Infirmary, Hull, U.K.
  3. 3Department of Medicine, York Hospital, York, U.K.
  1. 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: v.jayagopal{at}hull.ac.uk

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 …

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