Document Type : Original Article


Endocrine and metabolism Research center,Department of Internal Medicine, Nemazee Hospital, Shiraz university of medical sciences, Shiraz, Iran


The present study is a systematic review of alternative systematic reviews of insulin resistance and the role of sex steroids on leptin levels. In this study, 80 articles were examined by searching the words "Insulin", "Patients undergoing surgery" and "Sex steroids". Sex hormone-binding globulin (SHBG) assay is a sequential 2-step immune enzymatic (sandwich) method. The patient sample is added to the reaction vessel along with paramagnetic particles coated with monoclonal antibody against sex hormone binding globulin (SHBG) and saline buffer with protein. After incubation in a reaction vessel, the materials attached to the solid phase are held in a magnetic field. while unbound materials are washed away. A second monoclonal anti-SHBG antibody conjugated with alkaline phosphatase is added to the reaction vessel. After the second incubation in the reaction vessel, the material attached to the solid phase is held in a magnetic field while unbound materials are washed away. Next, the chemiluminescent substrate is added to the dish and the light produced by the reaction is measured with a luminometer. Light production is directly proportional to SHBG concentration in the sample. The amount of analyte in the sample is determined from a stored multipoint calibration curve. In men, about 45-65% of blood testosterone is normally bound to SHBG, and the rest is weakly and reversibly bound to albumin (the main blood protein). Only about 2-3% of testosterone is immediately available to tissues as free testosterone, but testosterone that is weakly bound to albumin is also biologically active and can be easily absorbed by body tissues. In women, compared to men, testosterone binds slightly more to SHBG in the blood. In women, SHBG plays an important role in regulating the levels of male sex hormones and estrogens in the body.


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