From the Research
Acarbose has been shown to increase sex hormone-binding globulin (SHBG) levels in certain studies, particularly in patients with polycystic ovary syndrome (PCOS) or insulin resistance. Acarbose is an alpha-glucosidase inhibitor primarily used to treat type 2 diabetes by slowing the digestion of carbohydrates, thereby reducing post-meal blood glucose spikes. While some diabetes medications like metformin have been associated with modest increases in SHBG levels in some studies, acarbose has been specifically linked to significant changes in SHBG in certain contexts, such as in the treatment of PCOS or insulin-resistant patients 1, 2. SHBG is a protein that binds to sex hormones like testosterone and estrogen, regulating their bioavailability in the bloodstream. SHBG levels can be influenced by various factors including liver function, thyroid hormones, insulin levels, and certain medications, but acarbose's mechanism of action may indirectly affect hormone regulation by improving insulin sensitivity.
Key Findings
- A study published in 2001 found that acarbose treatment in hyperinsulinaemic women with PCOS resulted in a significant increase in SHBG serum concentrations, along with improvements in clinical symptoms such as acne and menstrual regularity 1.
- Another study from 2005 confirmed that low-dose acarbose administered to obese patients with PCOS promoted an increase in SHBG, along with reductions in free androgen index and BMI, and improvements in hirsutism and menstrual pattern 2.
- However, it's essential to note that these findings may not be generalizable to all populations, and more research is needed to fully understand the effects of acarbose on SHBG levels in different contexts.
Clinical Implications
- If you're concerned about SHBG levels, medications like oral estrogens or thyroid hormones are more commonly associated with increasing SHBG, while conditions like insulin resistance and obesity tend to decrease SHBG levels.
- Acarbose may be a useful therapeutic option for patients with PCOS or insulin resistance who also have low SHBG levels, given its potential to improve insulin sensitivity and increase SHBG production.
- Further research is needed to explore the molecular mechanisms by which acarbose regulates SHBG production and to determine its clinical implications in various patient populations 3.