ROLE OF SEX HORMONE BINDING GLOBULIN AS AN INDICATOR OF INSULIN RESISTANCE

Abstract

Objective: To determine the role of Sex Hormone Binding Globulin (SHBG) in cases of hyperinsulinemia and insulin resistance among our population.

Material and Methods: It was a cross-sectional analytical study conducted at Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi, from Jun 2022 – Dec 2022. Study is comprised of total 90 samples consisting of both males and females. Study individuals were categorized as Pre-Diabetic and Diabetic according to their fasting plasma glucose levels. Fasting plasma insulin levels were done on Advia Centaur XPT Chemiluminescence Immunoassay analyser. Serum SHBG was done on Immulite 2000 by chemiluminescent immunometric assay. Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was calculated from fasting glucose and insulin levels. Cut off value of 2.2 was used for labelling insulin resistance. Data was analyzed on SPSS version 23. Mean and standard deviation (SD) was calculated for glucose, insulin and SHBG. T test was used to compare means of pre diabetic and diabetic groups. Pearson’s correlation was used to establish correlation between SHBG and HOMA-IR.

Results: Our study included 57 males and 33 females with mean age of 47±11 years and 47±12 years, respectively. SHBG levels were significantly higher in pre-diabetics as compared to diabetics. The Pearson’s correlation between SHBG and Fasting serum insulin is weak negative (r = 0.3, p = -0.23), same is between SHBG and HOMA-IR (r = 0.25, p = -0.86), showing no significant association between SHBG and HOMA-IR among our population. However, two tailed t-test showed marked difference between means of serum SHBG, fasting serum insulin and HOMA-IR among diabetic and pre-diabetic groups with 95% confidence Interval.

Conclusion: The negative association of SHBG with insulin resistance is not marked in our population. Various epidemiological, external and metabolic factors could affect and should be excluded before establishing this negative correlation between SHBG and Insulin resistance for predicting the development of diabetes mellitus (DM)

Key Words: SHBG, Hyperinsulinemia, HOMA-IR, Correlation