Endocrine Abstracts

Objective: The association of SHBG levels with obesity, hyperinsulinemia and metabolic abnormalities is well recognized in both men and women. Recent data suggest that SHBG levels are an important predictor of cardiovascular disease (CVD) risk. Several methods have been used for the measurement of adiposity including ultrasonography (U/S) which is a reliable and low-cost method. We used U/S to assess regional adiposity and investigated possible associations with SHBG levels.

Methods: 309 apparently healthy individuals (124 men and 185 women, mean age 43.9±9) without a history of diabetes or hypertension were examined for indices of the metabolic syndrome. None of the subjects was taking hormone therapy. The thickness of abdominal subcutaneous and peritoneal fat layer was estimated by U/S. Clinical parameters of obesity such as waist and hip circumference and BMI were recorded and SHBG, insulin, glucose and lipid levels were measured.

Results: SHBG levels were inversely correlated with peritoneal fat (P=0.003) whereas there was no significant association with subcutaneous fat. Lower SHBG levels were associated with increased waist circumference, decreased hip circumference, increased BMI, higher HOMA - Insulin Resistance Index and insulin levels (P<0.02). Step multivariate analysis showed that peritoneal fat, hip circumference and insulin levels were independently associated with SHBG levels. Significant associations were also found with age (P=0.047).

Conclusions: Peritoneal but not subcutaneous adiposity, as assessed by U/S, is inversely associated with SHBG levels. U/S seems to be a simple, low-cost method for the assessment of central adiposity in apparently healthy individuals. SHBG levels, which have been recognized as a risk factor for CVD, are highly correlated with indices of either protective type (hip) or high-risk type (peritoneal and waist) regional adiposity, indirectly supporting the importance of regional adiposity to the risk for metabolic syndrome and cardiovascular disease.