Correlation between sex hormone-binding globulin and peripheral europathy in type 2 diabetes mellitus

Abstract:

Objective：To investigate the correlation between sex hormone-binding globulin（SHBG） and diabetic peripheral neuropathy （DPN） in type 2 diabetes mellitus（T2DM）. Methods：A total of 238 patients with T2DM were enrolled in our hospital from January 2014 to January 2017. They were divided into T2DM group（n=96） and DPN group（n=142）. DPN patients were divided into three subgroups including mild（n=52），moderate（n=48） and severe（n=42） according to the Toronto score（TCSS）. The clinical data，bio－chemical indexes，neurophysiological indexes，serum SHBG and sex hormone levels were analyzed，and then the correlation between SHBG level and DPN correlation index was analyzed. Finally，logistic regression analysis was used to analyze the influencing factors of DPN. Results：Compared with those of T2DM group，the age of DPN group was significantly higher，BMI value was significantly decreased，with statistically significant differences（P<0.05）. The levels of systolic blood pressure（SBP），triglyc－eride（TG），total cholesterol（TC），low density lipoprotein-choles－terol（LDL-C） and blood uric acid（BUA） were significantly higher in the DPN group than in T2DM group（P<0.05），while diastolic blood pressure（DBP），fasting blood-glucose（FPG），glycosylated hemoglobin（HbA1c），high density lipoprotein-cholesterol（HDL-C），blood urea nitrogen（BUN），alanine aminotransferase（ALT），aspartate aminotransferase（AST），alkaline phosphatase（ALP） and glutamyl transpeptidase（γ-GT） were not（P>0.05）. The levels of serum SHBG，total testosterone（T） and total estradiol（E2） were sig－nificantly decreased in DPN group（P<0.05）. In addition，the MVC and SCV were significantly decreased in DPN group than in T2DM group（P<0.05，P<0.01）. The difference between the three subgroups of DPN was obvious in above indicators，with the increase of DPN severity（P<0.05）. Pearson correlation analysis showed that there were negative correlation between SHBG level and TG，TC，LDL-C and BUA in DPN patients（r=-0.562，-0.412，-0.476，-0.854，P<0.05），and positively correlated with MVC and SCV（r=0.693，0.782；P<0.05）. Logistic regression analysis showed that the levels of SUA，SHBG，E2 and T were the risk factors of DPN（OR=0.678，95%CI=0.321 to 1.093；OR=3.237，95%CI=2.671 to 5.613；OR=1.674，95%CI=1.031 to 3.012；OR=0.741，95%CI=0.423 to 0.881，P<0.05）. Conclusion：The level of SHBG is related to DPN，and the decrease of SHBG may be a risk factor for the occurrence and development of DPN. It may also be one of the most important predictors of T2DM vascular complications.