Sex hormone-binding globulin levels and cardiovascular risk factors in morbidly obese subjects before and after weight reduction induced by diet or malabsorptive surgery

Atherosclerosis. 2002 Apr;161(2):455-62. doi: 10.1016/s0021-9150(01)00667-0.


One of the main goals of weight reduction in morbidly obese subjects is its benefit on coronary heart disease (CHD) risk. A cross-sectional study was designed to randomly assign 79 morbidly obese subjects (27 men and 52 women; age: 30-45 years) either to a diet protocol (20 kcal per kg fat-free mass (FFM); 55% carbohydrates, 30% fat, and 15% proteins) or to malabsorptive surgery (biliopancreatic diversion). Fatness parameters, measured by dual-energy X-ray absorptiometry, lipid profile, insulin, leptin, sex steroid hormones and sex hormone-binding globulin (SHBG) levels were compared at baseline and 1 year after the beginning of the study. The data showed that plasma SHBG levels, but not testosterone levels, correlated negatively to fasting insulin levels and positively to HDL-cholesterol in both men and women. Total leptin levels were significantly lower (P<0.0001) in post-BPD subjects of both sexes compared to dietary treated obese subjects. The logarithm of plasma leptin correlated significantly and positively with insulin but negatively with SHBG.A step-down regression analysis showed that FFM and SHBG, but not insulin levels, were the most powerful independent variables for predicting HDL-cholesterol levels in morbidly obese patients. The negative relationship between SHBG levels and CHD risk appears to be mediated by a concomitant variation in body fatness. Finally, in obese patients, SHBG levels seem to be an indicator of total adiposity rather than an index of an altered insulin/glucose homeostasis.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Biomarkers / analysis
  • Body Composition
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / epidemiology
  • Cholesterol, HDL / metabolism*
  • Cohort Studies
  • Cross-Sectional Studies
  • Diet, Fat-Restricted
  • Female
  • Gastroplasty
  • Humans
  • Incidence
  • Leptin / metabolism*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity, Morbid / diet therapy*
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Probability
  • Regression Analysis
  • Risk Factors
  • Sensitivity and Specificity
  • Sex Hormone-Binding Globulin / metabolism*
  • Weight Loss


  • Biomarkers
  • Cholesterol, HDL
  • Leptin
  • Sex Hormone-Binding Globulin