Endocrine Abstracts

Aim: Low sex hormone-binding globulin (SHBG) is accompanied with onset of diabetes (DM) and increased cardiovascular risk (CVR). Proinflammatory cytokines, including adiponectin (APN) influence SHBG production. Lipid accumulation product (LAP) advocates as an indicator of increased CVR. We investigated the influence of different types of DM and sex on CVR through changes in SHBG and related risk factors.

Methods: Due to the non-normal distribution of individual dependent variables, they were log transformed [HbA1c, homocysteine (HCY), SHBG, interleukin-6 (IL-6), triglycerides (TG)]. Differences for analysed variables were tested using two factors analysis of variance (ANOVA) by gender, type of diabetes (DM1, DM2 and latent autoimmune: LADA) and their interaction. ANOVA and Tukey’s post hoc test was also used for testing differences according to LAP quartiles (1^st group: LAP< Q1; 2^nd group: Q1 ≤ LAP< Med; 3^rd group: Med ≤ LAP< Q3, 4^th group: LAP≥ Q3), separately in women and men. For all statistical tests, a significance level of 5% was considered statistically significant.

Results: SHBG level was significantly higher in women (especially in DM1) in comparison to men, and in autoimmune diabetes (DM1 and LADA) in comparison to DM2. There was no difference in SHBG between DM1 and LADA. Statistically significant interaction indicates that SHBG does not behave approximately equally between men and women according to the type of diabetes. APN level was significantly higher in women, without differences according to type of DM. High density lipoprotein (HDL) and apolipoprotein A1 (ApoA1) were higher in women and those with autoimmune diabetes (DM1 and LADA) in comparison with DM2, with no statistical difference between DM1 and LADA. Significant differences were determined in women and men for Apo A1, HDL, TG and HCY according to LAP quartiles. In women significant differences were determined for SHBG, fasting C-peptide (FCP) and IL-6; the difference for APN was bordered (P=0.068). When the differences were significant, higher quartiles of LAP are characterised with increased TG, HCY, FCP and IL-6, whereas SHBG, ApoA1, APN and HDL were decreased.

Conclusions: Lower values of SHBG, HDL i Apo A1 in men and in DM2 pointed at higher CVR. APN was significantly higher in women without the difference according to the type of DM, while SHBG, HDL, and ApoA1 levels were higher in women and those with DM1 and LADA in comparison with DM2 suggesting CV protection in women with autoimmune diabetes.