Association of sex hormone-binding globulin with nonalcoholic fatty liver disease in Chinese adults

Jing Luo; Qian Chen; Tianran Shen; Xu Wang; Wanjun Fang; Xiaocai Wu; Zenan Yuan; Gengdong Chen; Wenhua Ling; Yuming Chen

doi:10.1186/s12986-018-0313-8

Association of sex hormone-binding globulin with nonalcoholic fatty liver disease in Chinese adults

Nutr Metab (Lond). 2018 Nov 8:15:79. doi: 10.1186/s12986-018-0313-8. eCollection 2018.

Authors

Jing Luo^#^{1

2}, Qian Chen^#^{1

2

3}, Tianran Shen^{1

2}, Xu Wang^{1

2}, Wanjun Fang^{1

2}, Xiaocai Wu⁴, Zenan Yuan⁴, Gengdong Chen^{2

5}, Wenhua Ling^{1

2}, Yuming Chen^{2

5}

Affiliations

¹ 1Department of Nutrition, School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, 510080 China.
² 2Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, 510080 China.
³ 5Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120 China.
⁴ 4Department of Hepatic Surgery,The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630 China.
⁵ 3Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University (Northern Campus), Guangzhou, 510080 China.

^# Contributed equally.

Abstract

Background: Sex hormone-binding globulin (SHBG), a glycoprotein synthesized by hepatocytes, has been linked to insulin resistance and hepatic lipid metabolism and is suggested to be associated with nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the association of SHBG with NAFLD in Chinese adults.

Methods: We conducted a community-based, cross-sectional study in China involving 2912 participants aged 40-75 years old. All participants underwent detection for hepatic fat infiltration by ultrasound in addition to providing complete medical history and undergoing physical and blood biochemical examinations. The association of serum SHBG with the presence of NAFLD was reported by adjusted odds ratio after applying logistic regression models. To further explore the relationship between SHBG and NAFLD, mRNA expression of SHBG and hepatocyte nuclear factor 4-α (HNF4α), as well as intrahepatic triglycerides, were determined from the liver tissues of 32 subjects with different degrees of steatosis.

Results: Serum SHBG levels in patients with NAFLD (median, 43.8 nmol/L; interquartile range, 33.4-56.8 nmol/L) were significantly lower than those in non-NAFLD subjects (median, 63.4 nmol/L; interquartile range, 47.6-83.1 nmol/L). Serum SHBG levels were inversely correlated with WHR, trunk fat percentage, glucose, HOMA-IR, TG, UA and DHEAS, and were positively correlated with HDL-C levels (all p < 0.001). Logistic regression analysis indicated that serum SHBG levels were negatively associated with the presence of NAFLD in all subjects, as well as the subgroups stratified by sex, BMI and HOMA-IR (all p < 0.05). In human liver tissues, SHBG and HNF4α mRNA expression decreased along with the elevated grade of hepatic steatosis. Both SHBG and HNF4α mRNA expression levels were negatively correlated with intrahepatic triglycerides.

Conclusions: These results demonstrate that SHBG levels were negatively associated with the presence of NAFLD in middle-aged and elderly Chinese adults.

Keywords: Hepatic steatosis; Intrahepatic triglyceride; Nonalcoholic fatty liver disease; Sex hormone-binding globulin.