Sex Hormone Binding Globulin As a Valuable Biochemical Marker in Predicting Gestational Diabetes Mellitus

Overview

Journal BMC Womens Health

Publisher Biomed Central

Specialty Gynecology & Obstetrics

Date 2017 Mar 11

PMID 28279160

Citations 23

Authors

Manal Abdalla Tawfeek

Eman Mohamad Alfadhli

Abdulfatah Marawan Alayoubi

Hesham Ahmad El-Beshbishy

Fawzia Ahmad Habib

Affiliations

Soon will be listed here.

Abstract

Background: Circulating Sex hormone binding globulin (SHBG) levels are inversely associated with insulin resistance. This study was conducted to compare maternal serum SHBG level between pregnant women with normal glucose tolerance and those with gestational diabetes (GDM) and to investigate the roll of SHBG in GDM diagnosis.

Methods: This was a case controlled study of 90 pregnant women, 45 women with GDM and 45 matched controls, attending obstetrics clinic at Ohud Hospital, Madina, Saudi Arabia between April 2014 and March 2015. Measurement of serum SHBG levels by Enzyme-linked immunosorbent assay (ELISA) method were done between 24 and 28 weeks of gestation. The best cut-off point of SHBG to diagnose GDM was calculated in receiver operating characteristic curve.

Results: Compared with the control group, SHBG concentrations were significantly lower in the GDM group; median 23 nmol/L (18-30) vs. 78 nmol/L (65-96), p < 0.001). The cut off value 50 nmol/L of the SHBG had 90% sensitivity and 96% specificity to diagnose GDM.

Conclusion: Patients with GDM have lower circulating levels of SHBG than normal glucose tolerance pregnant women. Circulating concentrations of SHBG represent a potentially useful new biomarker for prediction of risk of GDM beyond the currently established clinical and demographic risk factors.

Citing Articles

Insulin resistance unraveled: Hormonal correlations in gestational diabetes.

Chen S, Bai X, Yin X, Bai L J Med Biochem. 2025; 43(6):835-842.

PMID: 39876919 PMC: 11771963. DOI: 10.5937/jomb0-49981.

Association Between SHBG Levels and Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis.

Malvi A, Shabil M, Khatib M, R R, Kaur M, Srivastava M J Clin Hypertens (Greenwich). 2025; 27(1):e14977.

PMID: 39835844 PMC: 11771790. DOI: 10.1111/jch.14977.

SHBG and Insulin resistance - Nexus revisited.

Dinakaran A, Ar S, Rajagambeeram R, Nanda S, Daniel M Bioinformation. 2024; 20(8):816-821.

PMID: 39411775 PMC: 11471403. DOI: 10.6026/973206300200816.

Sex hormone-binding globulin is a valuable diagnostic indicator of gestational diabetes mellitus.

Bruno B, Blessing M, Izuchukwu M, Terry G, Faeren D Ghana Med J. 2024; 58(1):53-59.

PMID: 38957276 PMC: 11215231. DOI: 10.4314/gmj.v58i1.8.

Genetically predicted high sex hormone binding globulin was associated with decreased risk of polycystic ovary syndrome.

Guo X, Chen L, He J, Zhang X, Xu S BMC Womens Health. 2024; 24(1):357.

PMID: 38902677 PMC: 11188236. DOI: 10.1186/s12905-024-03144-6.

References

White D, Griffiths M, Anyaoku V, Koistinen R, Seppala M, Franks S . Diurnal variation of sex hormone binding globulin and insulin-like growth factor binding protein-1 in women with polycystic ovary syndrome. Clin Endocrinol (Oxf). 1995; 43(2):159-65. DOI: 10.1111/j.1365-2265.1995.tb01910.x. View

Nanda S, Savvidou M, Syngelaki A, Akolekar R, Nicolaides K . Prediction of gestational diabetes mellitus by maternal factors and biomarkers at 11 to 13 weeks. Prenat Diagn. 2011; 31(2):135-41. DOI: 10.1002/pd.2636. View

Stanley K, Fraser R, Bruce C . Physiological changes in insulin resistance in human pregnancy: longitudinal study with the hyperinsulinaemic euglycaemic clamp technique. Br J Obstet Gynaecol. 1998; 105(7):756-9. DOI: 10.1111/j.1471-0528.1998.tb10207.x. View

Sun L, Jin Z, Teng W, Chi X, Zhang Y, Ai W . SHBG in GDM maternal serum, placental tissues and umbilical cord serum expression changes and its significance. Diabetes Res Clin Pract. 2012; 99(2):168-73. DOI: 10.1016/j.diabres.2012.05.019. View

OLeary P, Boyne P, Flett P, Beilby J, James I . Longitudinal assessment of changes in reproductive hormones during normal pregnancy. Clin Chem. 1991; 37(5):667-72. View

Smirnakis K, Plati A, Wolf M, Thadhani R, Ecker J . Predicting gestational diabetes: choosing the optimal early serum marker. Am J Obstet Gynecol. 2007; 196(4):410.e1-6. DOI: 10.1016/j.ajog.2006.12.011. View

Thadhani R, Wolf M, Hsu-Blatman K, Sandler L, Nathan D, Ecker J . First-trimester sex hormone binding globulin and subsequent gestational diabetes mellitus. Am J Obstet Gynecol. 2003; 189(1):171-6. DOI: 10.1067/mob.2003.343. View

Kerlan V, Nahoul K, Le Martelot M, Bercovici J . Longitudinal study of maternal plasma bioavailable testosterone and androstanediol glucuronide levels during pregnancy. Clin Endocrinol (Oxf). 1994; 40(2):263-7. DOI: 10.1111/j.1365-2265.1994.tb02478.x. View

Catalano P, Tyzbir E, Roman N, Amini S, SIMS E . Longitudinal changes in insulin release and insulin resistance in nonobese pregnant women. Am J Obstet Gynecol. 1991; 165(6 Pt 1):1667-72. DOI: 10.1016/0002-9378(91)90012-g. View

10.

Caglar G, Ozdemir E, Cengiz S, Demirtas S . Sex-hormone-binding globulin early in pregnancy for the prediction of severe gestational diabetes mellitus and related complications. J Obstet Gynaecol Res. 2012; 38(11):1286-93. DOI: 10.1111/j.1447-0756.2012.01870.x. View

11.

Kopp H, Festa A, Krugluger W, Schernthaner G . Low levels of Sex-Hormone-Binding Globulin predict insulin requirement in patients with gestational diabetes mellitus. Exp Clin Endocrinol Diabetes. 2001; 109(7):365-9. DOI: 10.1055/s-2001-17408. View

12.

Le T, Nestler J, Strauss 3rd J, Wickham 3rd E . Sex hormone-binding globulin and type 2 diabetes mellitus. Trends Endocrinol Metab. 2011; 23(1):32-40. PMC: 3351377. DOI: 10.1016/j.tem.2011.09.005. View

13.

Metzger B, Gabbe S, Persson B, Buchanan T, Catalano P, Damm P . International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010; 33(3):676-82. PMC: 2827530. DOI: 10.2337/dc09-1848. View

14.

Bartha J, Comino-Delgado R, Romero-Carmona R . Sex hormone-binding globulin in gestational diabetes. Acta Obstet Gynecol Scand. 2001; 79(10):839-45. View

15.

Key T, Pike M, Moore J, Wang D, Morgan B . The relationship of free fatty acids with the binding of oestradiol to SHBG and to albumin in women. J Steroid Biochem. 1990; 35(1):35-8. DOI: 10.1016/0022-4731(90)90142-f. View

16.

Ding E, Song Y, Manson J, Hunter D, Lee C, Rifai N . Sex hormone-binding globulin and risk of type 2 diabetes in women and men. N Engl J Med. 2009; 361(12):1152-63. PMC: 2774225. DOI: 10.1056/NEJMoa0804381. View

17.

Veltman-Verhulst S, van Haeften T, Eijkemans M, de Valk H, Fauser B, Goverde A . Sex hormone-binding globulin concentrations before conception as a predictor for gestational diabetes in women with polycystic ovary syndrome. Hum Reprod. 2010; 25(12):3123-8. DOI: 10.1093/humrep/deq272. View

18.

Kim C, Sen A, Osborne E, Lee J, Richardson C . Associations between glucose tolerance and sex hormone binding globulin among women with recent gestational diabetes mellitus. Diabetes Res Clin Pract. 2011; 93(3):e110-2. PMC: 3175320. DOI: 10.1016/j.diabres.2011.06.001. View