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Sex hormone binging globulin as an indicator of insulin resistance in type 1 diabetes.

Andrzej S. Januszewski,Wayne Rankin,David N. O’Neal,G. Wittert,Alicia Jenkins

Published 2025 in Diabetes Research and Clinical Practice

ABSTRACT

BACKGROUND Sex hormone-binding globulin (SHBG) regulates sex hormone bioavailability and is a marker of hepatic insulin resistance. AIM Determine the relationship of circulating SHBG concentration with components of the metabolic syndrome (MetS) and estimated insulin sensitivity (eIS) in adults with and without T1D. METHODS Serum SHBG concentrations were determined in 102 adults with T1D and 111 Controls (39% and 41% males, mean(SD): age 39(14) and 38(13) yrs., BMI 26.9(5.4) and 25.8(4.5) kg/m2). RESULTS SHBG (median(LQ,UQ) was higher in T1D vs. Controls: 66.1(39.3,98.7) vs. 45.5(30.3,74.8) nmol/L, p = 0.001; and ≈2-fold higher in females than males in both groups, p < 0.0001. SHBG correlated with eIS and was lower with vs. without MetS: T1D (51(32,71) vs. 79(46,106) nmol/L, p = 0.007), Controls (35(30,43) vs. 51(31,84) nmol/L, p = 0.03). In both groups there were significant associations of lower waist-to-hip ratio, waist-to-height ratio, BMI, triglycerides, LDL-C and higher eIS with an increase in sex-specific SHBG concentration tertiles (p < 0.05). In both groups SHBG decreased with number of MetS components, p(trend) = 0.005 and 0.0006, respectively. CONCLUSION In adults with T1D, SHBG decreases with increasing insulin resistance and MetS components. These findings support a potential role for SHBG as a biomarker of metabolic health in T1D, but further studies are needed to determine its clinical utility in identifying individuals who may benefit from interventions targeting insulin sensitivity.

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