Comments on 'Low serum sex hormone binding globulin is associated with nonalcoholic fatty liver disease in type 2 diabetic patients '

摘要

Nonalcoholic fatty liver disease (NAFLD) is the liver manifestation of metabolic syndrome, visceral obesity and insulin resistance, all of which are associated with increased risk of type 2 diabetes mellitus and atherosclerosis.1 NAFLD is characterized by an increase in hepatic triglyceride content with or without inflammation and fibrosis. NAFLD is one of the most common causes of elevated aminotransferases worldwide including Asia2 and is a public health problem due to high prevalence and risk of developing nonalcoholic steatohepatitis, cirrhosis and liver failure.3 The development of NAFLD has been shown to be related to insulin resistance in most studies. Many studies have shown an inverse relationship between obesity, insulin resistance, metabolic syndrome and type 2 diabetes and serum testosterone and sex-hormone-binding protein (SHBG) concentrations. The manuscript by Hua et al. in this issue of the journal attempts to clarify the relative roles of serum SHBG and testosterone in the development of NAFLD in men and women with type 2 diabetes in a case-control study.