Prediction of Insulin Resistance and Impaired Fasting Glucose Based on Sex Hormone-Binding Globulin (SHBG) Levels in Polycystic Ovary Syndrome

Objective. Decreased synthesis of sex hormone-binding globulin (SHBG) related to hyperinsulinemia is one of the disturbances characteristic of polycystic ovary syndrome (PCOS). Hyperinsulinemia is a compensatory mechanism for liver insulin resistance (IR); thus, SHBG may be considered as a surrogate...

Full description

Saved in:
Bibliographic Details
Main Authors: Aleksandra Biernacka-Bartnik, Piotr Kocełak, Aleksander Jerzy Owczarek, Piotr Choręza, Monika Puzianowska-Kuźnicka, Leszek Markuszewski, Paweł Madej, Jerzy Chudek, Magdalena Olszanecka-Glinianowicz
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:International Journal of Endocrinology
Online Access:http://dx.doi.org/10.1155/2022/6498768
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832567682287796224
author Aleksandra Biernacka-Bartnik
Piotr Kocełak
Aleksander Jerzy Owczarek
Piotr Choręza
Monika Puzianowska-Kuźnicka
Leszek Markuszewski
Paweł Madej
Jerzy Chudek
Magdalena Olszanecka-Glinianowicz
author_facet Aleksandra Biernacka-Bartnik
Piotr Kocełak
Aleksander Jerzy Owczarek
Piotr Choręza
Monika Puzianowska-Kuźnicka
Leszek Markuszewski
Paweł Madej
Jerzy Chudek
Magdalena Olszanecka-Glinianowicz
author_sort Aleksandra Biernacka-Bartnik
collection DOAJ
description Objective. Decreased synthesis of sex hormone-binding globulin (SHBG) related to hyperinsulinemia is one of the disturbances characteristic of polycystic ovary syndrome (PCOS). Hyperinsulinemia is a compensatory mechanism for liver insulin resistance (IR); thus, SHBG may be considered as a surrogate marker of liver IR. Therefore, this study aimed to assess the prediction of IR and impaired fasting glucose (IFG) based on SHBG levels in women with PCOS. Methods. This analysis included data retrieved from medical records of 854 patients with PCOS hospitalized in the Gynecological Endocrinology Clinic from 2012 to 2019. Data including anthropometric parameters, fasting plasma glucose, insulin, and SHBG levels were analyzed. BMI and HOMA-IR were calculated with standard formulas. Results. IFG and IR assessed based on HOMA-IR values > 2.0 were found in 19.5% and 47.8% of the study group, respectively. Empirical optimal cutoff values for SHBG levels were ≤41.5 nmol/L typical for IR (AUC 0.711, sensitivity 61.1%, specificity 71.6%, positive predictive value (PPV) 70.7%, and negative predictive value (NPV) 62.1%). The probability of insulin resistance occurrence for SHBG concentration 26.1 nmol/L (the lower normal range) was 61.6% (95% CI: 57.4%–65.8%). The SHBG concentration of 36.4 nmol/L and 8.1 nmol/L was related to a 10% and 20% probability of IFG, respectively. Conclusion. In conclusion, this is the first study estimating the probability of liver IR and IFG occurrence based on SHBG levels in women with PCOS. Despite the low sensitivity, SHBG level below 42 nmol/L should cause closer monitoring for the fatty liver and prediabetes.
format Article
id doaj-art-bd313740f6da4fe0867f5d46a8037152
institution Kabale University
issn 1687-8345
language English
publishDate 2022-01-01
publisher Wiley
record_format Article
series International Journal of Endocrinology
spelling doaj-art-bd313740f6da4fe0867f5d46a80371522025-02-03T01:00:47ZengWileyInternational Journal of Endocrinology1687-83452022-01-01202210.1155/2022/6498768Prediction of Insulin Resistance and Impaired Fasting Glucose Based on Sex Hormone-Binding Globulin (SHBG) Levels in Polycystic Ovary SyndromeAleksandra Biernacka-Bartnik0Piotr Kocełak1Aleksander Jerzy Owczarek2Piotr Choręza3Monika Puzianowska-Kuźnicka4Leszek Markuszewski5Paweł Madej6Jerzy Chudek7Magdalena Olszanecka-Glinianowicz8Department of Gynecological EndocrinologyPathophysiology UnitHealth Promotion and Obesity Management UnitDepartment of StatisticsDepartment of Human EpigeneticsCenter Heart and Vascular Diseases Internal and Metabolic Diseases Mazovian Specialist Hospital in RadomDepartment of Gynecological EndocrinologyPathophysiology UnitHealth Promotion and Obesity Management UnitObjective. Decreased synthesis of sex hormone-binding globulin (SHBG) related to hyperinsulinemia is one of the disturbances characteristic of polycystic ovary syndrome (PCOS). Hyperinsulinemia is a compensatory mechanism for liver insulin resistance (IR); thus, SHBG may be considered as a surrogate marker of liver IR. Therefore, this study aimed to assess the prediction of IR and impaired fasting glucose (IFG) based on SHBG levels in women with PCOS. Methods. This analysis included data retrieved from medical records of 854 patients with PCOS hospitalized in the Gynecological Endocrinology Clinic from 2012 to 2019. Data including anthropometric parameters, fasting plasma glucose, insulin, and SHBG levels were analyzed. BMI and HOMA-IR were calculated with standard formulas. Results. IFG and IR assessed based on HOMA-IR values > 2.0 were found in 19.5% and 47.8% of the study group, respectively. Empirical optimal cutoff values for SHBG levels were ≤41.5 nmol/L typical for IR (AUC 0.711, sensitivity 61.1%, specificity 71.6%, positive predictive value (PPV) 70.7%, and negative predictive value (NPV) 62.1%). The probability of insulin resistance occurrence for SHBG concentration 26.1 nmol/L (the lower normal range) was 61.6% (95% CI: 57.4%–65.8%). The SHBG concentration of 36.4 nmol/L and 8.1 nmol/L was related to a 10% and 20% probability of IFG, respectively. Conclusion. In conclusion, this is the first study estimating the probability of liver IR and IFG occurrence based on SHBG levels in women with PCOS. Despite the low sensitivity, SHBG level below 42 nmol/L should cause closer monitoring for the fatty liver and prediabetes.http://dx.doi.org/10.1155/2022/6498768
spellingShingle Aleksandra Biernacka-Bartnik
Piotr Kocełak
Aleksander Jerzy Owczarek
Piotr Choręza
Monika Puzianowska-Kuźnicka
Leszek Markuszewski
Paweł Madej
Jerzy Chudek
Magdalena Olszanecka-Glinianowicz
Prediction of Insulin Resistance and Impaired Fasting Glucose Based on Sex Hormone-Binding Globulin (SHBG) Levels in Polycystic Ovary Syndrome
International Journal of Endocrinology
title Prediction of Insulin Resistance and Impaired Fasting Glucose Based on Sex Hormone-Binding Globulin (SHBG) Levels in Polycystic Ovary Syndrome
title_full Prediction of Insulin Resistance and Impaired Fasting Glucose Based on Sex Hormone-Binding Globulin (SHBG) Levels in Polycystic Ovary Syndrome
title_fullStr Prediction of Insulin Resistance and Impaired Fasting Glucose Based on Sex Hormone-Binding Globulin (SHBG) Levels in Polycystic Ovary Syndrome
title_full_unstemmed Prediction of Insulin Resistance and Impaired Fasting Glucose Based on Sex Hormone-Binding Globulin (SHBG) Levels in Polycystic Ovary Syndrome
title_short Prediction of Insulin Resistance and Impaired Fasting Glucose Based on Sex Hormone-Binding Globulin (SHBG) Levels in Polycystic Ovary Syndrome
title_sort prediction of insulin resistance and impaired fasting glucose based on sex hormone binding globulin shbg levels in polycystic ovary syndrome
url http://dx.doi.org/10.1155/2022/6498768
work_keys_str_mv AT aleksandrabiernackabartnik predictionofinsulinresistanceandimpairedfastingglucosebasedonsexhormonebindingglobulinshbglevelsinpolycysticovarysyndrome
AT piotrkocełak predictionofinsulinresistanceandimpairedfastingglucosebasedonsexhormonebindingglobulinshbglevelsinpolycysticovarysyndrome
AT aleksanderjerzyowczarek predictionofinsulinresistanceandimpairedfastingglucosebasedonsexhormonebindingglobulinshbglevelsinpolycysticovarysyndrome
AT piotrchoreza predictionofinsulinresistanceandimpairedfastingglucosebasedonsexhormonebindingglobulinshbglevelsinpolycysticovarysyndrome
AT monikapuzianowskakuznicka predictionofinsulinresistanceandimpairedfastingglucosebasedonsexhormonebindingglobulinshbglevelsinpolycysticovarysyndrome
AT leszekmarkuszewski predictionofinsulinresistanceandimpairedfastingglucosebasedonsexhormonebindingglobulinshbglevelsinpolycysticovarysyndrome
AT pawełmadej predictionofinsulinresistanceandimpairedfastingglucosebasedonsexhormonebindingglobulinshbglevelsinpolycysticovarysyndrome
AT jerzychudek predictionofinsulinresistanceandimpairedfastingglucosebasedonsexhormonebindingglobulinshbglevelsinpolycysticovarysyndrome
AT magdalenaolszaneckaglinianowicz predictionofinsulinresistanceandimpairedfastingglucosebasedonsexhormonebindingglobulinshbglevelsinpolycysticovarysyndrome