Serum sex hormone-binding globulin is a mediator of the association between intrahepatic lipid content and type 2 diabetes: the Maastricht Study. Simons, P., Valkenburg, O., van de Waarenburg, M. P. H., van Greevenbroek, M. M. J., Kooi, M. E., Jansen, J. F. A., Schalkwijk, C. G., Stehouwer, C. D. A., & Brouwers, M. Diabetologia, 2022. Simons, Pomme I H G Valkenburg, Olivier van de Waarenburg, Marjo P H van Greevenbroek, Marleen M J Kooi, M Eline Jansen, Jacobus F A Schalkwijk, Casper G Stehouwer, Coen D A Brouwers, Martijn C G J eng Germany Diabetologia. 2022 Sep 17. pii: 10.1007/s00125-022-05790-7. doi: 10.1007/s00125-022-05790-7.
Serum sex hormone-binding globulin is a mediator of the association between intrahepatic lipid content and type 2 diabetes: the Maastricht Study [link]Paper  doi  abstract   bibtex   
AIMS/HYPOTHESIS: Serum sex hormone-binding globulin (SHBG) has been proposed to act as a hepatokine that contributes to the extrahepatic complications observed in non-alcoholic fatty liver disease (NAFLD). However, it remains uncertain whether serum SHBG mediates the association between intrahepatic lipids (IHL) and type 2 diabetes. Therefore, we studied whether, and to what extent, serum SHBG mediates the association between IHL content and type 2 diabetes. METHODS: We used cross-sectional data from the Maastricht Study (n=1554), a population-based cohort study with oversampling of individuals with type 2 diabetes. Type 2 diabetes status was assessed by oral glucose tolerance test, and IHL content was measured using 3T Dixon MRI. Mediation analyses were performed to assess the role of serum SHBG in mediating the association between IHL content and type 2 diabetes. RESULTS: IHL content was significantly associated with type 2 diabetes in women and men (OR 1.08 [95% CI 1.04, 1.14] and OR 1.12 [95% CI 1.08, 1.17], respectively). Serum SHBG significantly mediated the association between IHL content and type 2 diabetes. The contribution of serum SHBG was higher in women (OR 1.04 [95% CI 1.02, 1.07]; proportion mediated 50.9% [95% CI 26.7, 81.3]) than in men (OR 1.02 [95% CI 1.01, 1.03]; proportion mediated 17.2% [95% CI 9.6, 27.6]). Repeat analyses with proxies of type 2 diabetes and adjustment for covariates did not substantially affect the results. CONCLUSIONS/INTERPRETATION: In this large-scale population-based cohort study, serum SHBG was found to be a mediator of the association between IHL content and type 2 diabetes. These findings extend our understanding of the potential mechanisms by which NAFLD is a risk factor for type 2 diabetes, and further elaborate on the role of SHBG as a hepatokine.
@article{RN309,
   author = {Simons, Pihg and Valkenburg, O. and van de Waarenburg, M. P. H. and van Greevenbroek, M. M. J. and Kooi, M. E. and Jansen, J. F. A. and Schalkwijk, C. G. and Stehouwer, C. D. A. and Brouwers, Mcgj},
   title = {Serum sex hormone-binding globulin is a mediator of the association between intrahepatic lipid content and type 2 diabetes: the Maastricht Study},
   journal = {Diabetologia},
   note = {Simons, Pomme I H G
Valkenburg, Olivier
van de Waarenburg, Marjo P H
van Greevenbroek, Marleen M J
Kooi, M Eline
Jansen, Jacobus F A
Schalkwijk, Casper G
Stehouwer, Coen D A
Brouwers, Martijn C G J
eng
Germany
Diabetologia. 2022 Sep 17. pii: 10.1007/s00125-022-05790-7. doi: 10.1007/s00125-022-05790-7.},
   abstract = {AIMS/HYPOTHESIS: Serum sex hormone-binding globulin (SHBG) has been proposed to act as a hepatokine that contributes to the extrahepatic complications observed in non-alcoholic fatty liver disease (NAFLD). However, it remains uncertain whether serum SHBG mediates the association between intrahepatic lipids (IHL) and type 2 diabetes. Therefore, we studied whether, and to what extent, serum SHBG mediates the association between IHL content and type 2 diabetes. METHODS: We used cross-sectional data from the Maastricht Study (n=1554), a population-based cohort study with oversampling of individuals with type 2 diabetes. Type 2 diabetes status was assessed by oral glucose tolerance test, and IHL content was measured using 3T Dixon MRI. Mediation analyses were performed to assess the role of serum SHBG in mediating the association between IHL content and type 2 diabetes. RESULTS: IHL content was significantly associated with type 2 diabetes in women and men (OR 1.08 [95% CI 1.04, 1.14] and OR 1.12 [95% CI 1.08, 1.17], respectively). Serum SHBG significantly mediated the association between IHL content and type 2 diabetes. The contribution of serum SHBG was higher in women (OR 1.04 [95% CI 1.02, 1.07]; proportion mediated 50.9% [95% CI 26.7, 81.3]) than in men (OR 1.02 [95% CI 1.01, 1.03]; proportion mediated 17.2% [95% CI 9.6, 27.6]). Repeat analyses with proxies of type 2 diabetes and adjustment for covariates did not substantially affect the results. CONCLUSIONS/INTERPRETATION: In this large-scale population-based cohort study, serum SHBG was found to be a mediator of the association between IHL content and type 2 diabetes. These findings extend our understanding of the potential mechanisms by which NAFLD is a risk factor for type 2 diabetes, and further elaborate on the role of SHBG as a hepatokine.},
   keywords = {Hepatokine
Mediation
Non-alcoholic fatty liver disease
Sex hormone-binding globulin
Type 2 diabetes},
   ISSN = {1432-0428 (Electronic)
0012-186X (Linking)},
   DOI = {10.1007/s00125-022-05790-7},
   url = {https://www.ncbi.nlm.nih.gov/pubmed/36114428},
   year = {2022},
   type = {Journal Article}
}

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