Korean J Fam Pract. 2017; 7(2): 271-275  https://doi.org/10.21215/kjfp.2017.7.2.271
Relationship between Sex-Hormone Binding Globulin and Non-Invasive Nonalcoholic Fatty Liver Fibrosis Models in Men
In-Ho Seo1, Hyung-Bin Lee1, Yong-Jae Lee1, Dong-Hyuk Jung2,*
1Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul; 2Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
Dong-Hyuk Jung
Tel: +82-31-331-8821, Fax: +82-31-331-8709
E-mail: balsan2@yuhs.ac
Received: June 17, 2016; Revised: August 15, 2016; Accepted: August 19, 2016; Published online: April 20, 2017.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Sex hormone-binding globulin (SHBG) is a serum glycoprotein produced predominantly in the hepatocytes. It is associated with metabolic syndrome, type II diabetes mellitus, cardiovascular disease, and nonalcoholic fatty liver disease (NAFLD). Liver biopsy is the gold standard diagnostic tool for NAFLD; however, the procedure is highly invasive. Many non-invasive serum NAFLD models have been developed to overcome this limitation. The objective of this study was to investigate the association between SHBG and two serum NAFLD fibrosis models in male Korean patients with hepatic steatosis.
Methods: We performed a retrospective cross-sectional study of 534 participants who were enrolled in a routine health examination program. The aspartate transaminase (AST) to alanine transaminase (ALT) ratio and the NAFLD fibrosis score were used as non-invasive serum NAFLD fibrosis models in this study; these were calculated for each patient. Multiple linear regression analysis was conducted to analyze the relationship between SHBG and the AST to ALT ratio, as well as the NAFLD fibrosis score.
Results: SHBG is positively correlated with both, AST to ALT ratio and the NAFLD fibrosis score. After adjusting for confounding factors, significant relationships between SHBG and both non-invasive NAFLD fibrosis models were found (P=0.000 and P=0.000).
Conclusion: The AST to ALT ratio and NAFLD fibrosis score are associated with higher serum SHBG levels in men with hepatic steatosis.
Keywords: Sex-Hormone Binding Globulin; Nonalcoholic Fatty Liver Disease; Aspartate Transaminase to Alanine Transaminase Ratio; Nonalcoholic Fatty Liver Disease Fibrosis Score
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