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The Journal of Clinical Endocrinology & Metabolism Vol. 90, No. 7 4419-4420
Copyright © 2005 by The Endocrine Society

Letter to the Editor

Letter re: The Biological Variation of Testosterone and Sex Hormone-Binding Globulin (SHBG) in Polycystic Ovarian Syndrome: Implications for SHBG as a Surrogate Marker of Insulin Resistance

Jardena J. Puder, Beat Müller and Ulrich Keller

Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital, CH-4031 Basel, Switzerland

Address correspondence to: Jardena J. Puder, Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland. E-mail: Puderj{at}uhbs.ch.

To the editor:

We read with great interest the paper from Jayagopal et al. (1) published in 2003 in the Journal for Clinical Endocrinology and Metabolism. In this paper, the authors assess the biological variability of two markers of insulin resistance, the homeostasis model assessment method (HOMA-IR) and the serum concentrations of SHBG. Thereby, fasting blood samples were collected at 4-d intervals on 10 consecutive occasions from 12 overweight patients with the polycystic ovary syndrome (PCOS) and 11 age- and weight-matched healthy controls. The authors found that, in contrast to the HOMA-IR, the intraindividual variation in SHBG was lower in patients with PCOS compared with controls.

However, in healthy regularly menstruating controls, we and others found that SHBG serum concentrations indeed show menstrual cycle-specific changes with an increase of the SHBG serum concentrations in the luteal phase, in parallel with changes in estradiol concentrations (2, 3, 4, 5). We did not observe similar changes for HOMA-IR. In our healthy controls, the intraindividual variance of SHBG during the follicular phase, i.e. a time period without menstrual cycle-specific changes, was very low. Actually, the percentage of variance of SHBG explained by the within-subject variance during the follicular phase (5%) was significantly smaller than for HOMA-IR (42%; P < 0.05). In this context, it would be informative to know the differences in the intraindividual variations of SHBG serum concentrations and of HOMA-IR between patients with PCOS and healthy controls, if the authors used only the data during the follicular phase for their controls.

Footnotes

A response to this letter was invited, but the authors of the original article chose not to provide one.

Received April 12, 2005.

References

  1. Jayagopal V, Kilpatrick ES, Jennings PE, Hepburn DA, Atkin SL 2003 The biological variation of testosterone and sex hormone-binding globulin (SHBG) in polycystic ovarian syndrome: implications for SHBG as a surrogate marker of insulin resistance. J Clin Endocrinol Metab 88:1528–1533[Abstract/Free Full Text]
  2. Blum CA, Muller B, Huber P, Kraenzlin M, Schindler C, De Geyter C, Keller U, Puder JJ 2005 Low-grade inflammation and estimates of insulin resistance during the menstrual cycle in lean and overweight women. J Clin Endocrinol Metab 90:3230–3235[Abstract/Free Full Text]
  3. Anttila L, Koskinen P, Irjala K, Kaihola HL 1991 Reference intervals for serum sex steroids and gonadotropins in regularly menstruating women. Acta Obstet Gynecol Scand 70:475–481[Medline]
  4. Plymate SR, Moore DE, Cheng CY, Bardin CW, Southworth MB, Levinski MJ 1985 Sex hormone-binding globulin changes during the menstrual cycle. J Clin Endocrinol Metab 61:993–996[Abstract]
  5. Schijf CP, van der Mooren MJ, Doesburg WH, Thomas CM, Rolland R 1993 Differences in serum lipids, lipoproteins, sex hormone binding globulin and testosterone between the follicular and the luteal phase of the menstrual cycle. Acta Endocrinol (Copenh) 129:130–133[Medline]




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