Influence of Sex Hormones on the Relationship Between Body Fat and Glycated Albumin Levels

Background: Previous studies have reported that glycated albumin (GA) is affected by body fat distribution. Sex hormones are reported to play an important role in fat metabolism. Aim: This study aimed to explore the influence of sex hormones on the relationship between body fat and GA in a community population. Methods: We recruited 763 middle-aged and elderly subjects with normal glucose tolerance from communities. GA was determined using the enzyme method, and serum estradiol (E2), total testosterone, and sex hormone binding globulin (SHBG) were detected using chemiluminescent microparticle immunoassays. Outcome: There was a statistically significant association between SHBG and GA remained after adjusting for body fat in both men and women. Results: The average serum GA levels were 13.40 1.10% in the 298 men and 465 postmenopausal women included in this study. GA presented a significant downward trend with increasing quartiles of total fat mass (FM), limb FM, and trunk FM in both men and women (all P for trend <.01). In men, total testosterone, free testosterone, and SHBG were positively correlated with GA (both P <.01), and the correlation between SHBG and GA remained after adjusting for body fat (P <.01). In women, E2, free testosterone, bioactive testosterone, and SHBG were correlated with GA (all P <.01); furthermore, the positive correlation between SHBG and GA and the inverse correlation between E2 and GA remained after adjusting for body fat (both P <.05). Multivariate linear regression analyses showed that in addition to trunk FM, SHBG was positively correlated with GA in both men and women (standardized i3 = 0.136, P =.035; standardized i3 = 0.101, P =.033); however, E2 was not independently correlated with GA in women. Clinical Implications: SHBG may contribute to the influence of body fat, especially trunk fat on GA levels. Strengths & Implications: This study used an automated bioelectrical impedance analyzer to measure segmental body composition including limb FM and trunk FM and further investigated the role of segmental body fat in the correlation between SHBG and GA. Sex hormones may explain in part why body fat content and distribution can alter GA levels. Conclusion: SHBG is positively correlated with serum GA levels, and this correlation is independent of total or segmental body fat. Copyright (C) 2020, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.