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• W2895852622 abstract "INTRODUCTION: Insulin resistance is defined as an impaired ability of plasmainsulin at usual concentrations to adequately promote peripheral glucosedisposal, suppress hepatic glucose output and inhibit very low densitylipoprotein (VLDL) output.Insulin resistance results in compensatory increase in insulinsecretion. The resulting hyperinsulinemia overcomes the insulinresistance for sometime and keeps the blood sugar in normal range.However when relative beta cell insufficiency (insulin secretioninsufficient for the level of hyperglycemia) also sets in, overt diabetesdevelops.Metabolic syndrome also known as Syndrome X is associatedwith increased risk of coronary heart disease and stroke. The features ofmetabolic syndrome include abdominal obesity, hyperinsulinemia,dyslipidemia, type 2 diabetes mellitus, and hypertension1. The corefeature is elevated insulin levels which develops early in the course ofdisease. AIM OF THE STUDY: To correlate the level of sex hormone binding globulin with levelof insulin resistance and (or) hyperinsulinemia in obese prepubertalchildren. DISCUSSION: The plasma SHBG concentration, originally considered to beunder the direct regulation of sex hormone levels, is now considered tobe under multi factorial regulation. Indeed, the basal production ofSHBG seems to be steroid independent and more related to generalmetabolic factors and nutritional status58,59. In this sense some hormonessuch as growth hormone, insulin like growth factor (IGF)-I and insulinmay play a more active role in the regulation of SHBG levels60.Recently, there has been increased interest in the role played by insulinin this multi regulation. It is now known that insulin has an inhibitoryeffect on synthesis of SHBG.By using cultured HepG2 cells, it has been found that insulin ispotent inhibitor of basal production of SHBG. This action may by adirect mechanism or by indirectly increasing free fraction of IGF1. Anyway, the relationship between insulin and SHBG is widespreadphenomenon in adults61 and is present even in neonates62. Therefore,evidence suggests that it is a more physiological process than wasoriginally thought63. Thus SHBG level could be a general marker forhyperinsulinemic insulin resistance. This would explain the observationthat a low serum SHBG level is a strong predictor for development ofNIDDM. Though numerous adult studies have already established negativecorrelation between insulin resistance and sex hormone binding globulinlevel, prepubertal period is ideal time to test the relationship. Duringpubertal progression, there are dynamic changes in the level of insulinresistance. Insulin resistance increased immediately at the onset ofpuberty (T2) but returns to near prepubertal level by the end of puberty(T5). Its peak occurs at T3 in both sexes64. Girls are more insulinresistant than boys at all pubertal stages. CONCLUSION: There is a strong negative correlation between SHBG and insulinresistant status.Low SHBG concentration is a stable integrated marker of insulinresistance and therefore has the characteristics to be potentially used as asurrogate measure of insulin resistance.Currently it is cost effective and also avoids the ordeals ofmeasuring fasting insulin indices.For the time being the utility of SHBG estimation is limited toserial monitoring of insulin resistance in individuals on treatment afterthe presence of insulin resistance is established by conventional means.An extensive study with large sample size with cases and controlis needed to determine the cut off value of SHBG for insulin resistance.With ethnic predisposition and drastic changes in life style thereis spiralling incidence of metabolic syndrome in Indian population.Studies in the direction of searching such a useful surrogate marker ofinsulin resistance syndrome will have great impact in combating thisepidemic." @default.
• W2895852622 created "2018-10-26" @default.
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• W2895852622 date "2006-09-01" @default.
• W2895852622 modified "2023-09-26" @default.
• W2895852622 title "Correlation between the Sex Hormone Binding Globulin Level and level of Insulin Resistance in Obese Prepubertal Children" @default.
• W2895852622 hasPublicationYear "2006" @default.
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