2000 Volume 43 Issue 8 Pages 657-667
First, profiles of sex hormone level and lipid metabolism in age-matched Japanese men with impaired glucose tolerance (IGT; n=22), non-insulin-dependent diabetes mellitus (NIDDM; n=36), ionships of the lipids and lipoprotein parameters to sex hormones, sex hormone-binding globulin (SHBG), insulin resistance (IR) score evaluated by HOMA model, estimated maximal oxygen uptake (VO2max), and abdominal fat accumulation were investigated in the 4 groups (C, IGT, NIDDM, and IGT+NIDDM). Body mass index (BMI) and waist-tohip ratio (WHR) in these patient groups increased significantly more than in the C group (p<0.05). The levels of the serum free testosterone (Free T) and high-density lipoprotein cholesterol (HDL-c) in the IGT and NIDDM groups were significantly lower than those in the C group (p<0.05). The level of SHBG in the NIDDM group was significantly lower than that in the C group. BMI, WHR, TC/HDL-c, LDL-c/HDL-c, FPG, FIRI, and IR score in the IGT+NIDDM group were significantly higher than those in the C group. On the other hand, HDL-c, free T, and SHBG levels in the IGT+NIDDM group were significantly lower than those in the C group. The IR score was elevated in the order NIDDM>IGT>C. Significant decreases in both Free T and SHBG levels in the patient groups were also observed after statistical adjustment for both BMI and WHR. A multiple regression analysis of lipid metabolism was performed for all 4 groups. In the C group, sex hormones and SHBG levels were not significantly associated with lipid and lipoprotein metabolism. In the IGT group, DHEA-s, total testosterone, and SHBG correlated siginificantly and independently with TC, HDL-c, and TG, respectively. In the NIDDM group, SHBG levels were significantly and independently associated with LDL-c/HDL-c. In the IGT+NIDDM group, total testosterone and VO2max were positively and independently related to HDL-c. Visceral fat area and SHBG were also independently related to TG. The IR score was independently associated with TC. VO2max and SHBG were negatively and independently related to TC/HDL-c. VO2max and IR score correlated independently with LDL/HDL-c. From these results, it was suggested that suppressed androgen and SHBG levels, and lipid abnormalities, may exist in patients with IGT and/or NIDDM, and insulin resistance, visceral fat accumulation, and endurance fitness, as well as lower levels of androgen and SHBG, were found to be independently related to lipid metabolism in the glucose-intolerant groups.
