AUTHORIZATION TO LEND AND REPRODUCE THE THESIS As the sole author of this thesis, I authorize Brown University to lend it to other institutions or individuals for the purpose of scholarly research. Date _______________03/22/2017 _____________________ Jinjie Liu, Author I future authorize Brown University to reproduce this thesis by photocopying or other means, in total or in part, at the request of other institutions or individuals for the purpose of scholarly research. Date _______________03/22/2017 _____________________ Jinjie Liu, Author Review of Sex Hormone-Binding Globlin, dietary factors and health Relation of Dietary Carbohydrates Intake to Circulating Sex Hormone-Binding Globulin Levels in Postmenopausal Women By Jinjie Liu B.S. Beijing Sport University Thesis Submitted in partial fulfillment of the requirements for the Degree of Master of Public Health in Brown University School of Public Health PROVIDENCE, RHODE ISLAND MAY, 2017 ii This thesis by Jinjie Liu is accepted in its present form by the Brown University School of Public Health as satisfying the thesis requirements for the degree of Master of Public Health Date:________________ ___________________________ Simin Liu, M.D., Ph.D., Advisor Date:________________ ___________________________ Xi Luo, Ph.D., Reader Date:________________ ___________________________ Patrick M. Vivier, M.D.,Ph.D. Director, Master of Public Health Program Approved by the Graduate Council Date:______________ _____________________________ Andrew G. Campbell , Dean of the Graduate School iii Vita Jinjie Liu was born on July 5th, 1993 in Lanzhou, China to Chun Liu and Sudi Zhang. During her study in Beijing Sport University in Beijing, China, she earned national scholarship, studied abroad in Indiana University Bloomington in Bloomington, Indiana for a year in school of Public Health. During that time, she was the team leader in Applied Physical Education lab taking care of children with special needs and was inducted into Honors Society. Growing passion in public health, she attended Brown University as a master of public health candidate after receiving her Bachelor of Science degree in Beijing Sport University in 2015. While pursing her master degree in Brown with a focus in biostatistics, she did intensive training on quantitative research and analysis, which helped her gain a better understanding on the public health issues holding the knowledge and tools she got. Jinjie did her summer internship at Global Biostatistics Department of Merck Serono in Beijing, assisting with clinical research on new drug development. Most recently, she has been helping with a research project in the Center for Alcohol and Addition Studies in Brown University as research assistant. In the meanwhile, she has been interning in SCIO Health Analytics in Hartford, Connecticut as a health care analyst, dealing with health insurance claim data and working with patients and health insurance companys. iv Preface and Acknowledgments I must first thank my thesis advisor Dr. Simin Liu, for being such a patient and supportive mentor who guided me through not only the work of my thesis, but also issues that I encountered with while pursuing my master degree at Brown. I was lucky enough to work with Mengna Huang, who gave me countless of useful information regarding my thesis as well as working together and finally got it published. She was an excellent example of being an outstanding student and a writer doing public health research. I also want to thank Xiaochen Lin, who also assisted me throughout the whole process, as a supervisor as well as a friend. Meanwhile, I want to thank my thesis reader Luo Xi, who has unbeatable computation skill and passion in big data research. I am grateful for all the help from Joann Barao, Dr. Vivier and Diane Schlacter while studying at Brown, without whom I might never made it for lots of opportunities. At the same time, I appreciate the opportunity Dr, Carey offered my as research assistant for the project that’s just within my interests. I also own a huge thank to my manager who offered me my current job, Emily Li. She is always in my concern and pushing me to grow and be better. To my family, my incredible parents, my grandma, who passed away while I was abroad with no chance to fly back to see her, and to my grandpa. v Table of Content PART 1: LITERATURE REVIEW – SEX HORMONE-BINDING GLOBLIN, DIETARY FACTORS AND HEALTH .......................................................................................................................................................... 1 SHBG AND SEXUAL HORMONES ................................................................................................................................... 1 Sex hormones and health ................................................................................................................................................ 2 SHBG and health .................................................................................................................................................................. 2 SHBG and women’s health ............................................................................................................................................. 4 SHBG AND LEADING FACTORS ..................................................................................................................................... 4 SHBG and lifestyle factors ............................................................................................................................................... 5 SHBG and weight related factors ................................................................................................................................ 5 SHBG AND DIETARY FACTORS ...................................................................................................................................... 6 SHBG and restricted diet .................................................................................................................................................. 7 SHBG and fiber intake ....................................................................................................................................................... 7 SHBG and fat intake ............................................................................................................................................................ 8 SHBG and meat consumption ....................................................................................................................................... 8 SHBG and protein intake .................................................................................................................................................. 9 SHBG and sugar intake ..................................................................................................................................................... 9 SHBG and carbohydrates intake .............................................................................................................................. 10 PART 2: RESEARCH PAPER – RELATION OF DIETARY CARBOHYDRATES INTAKE TO CIRCULATING SEX HORMONE-BINDING GLOBULIN LEVELS IN POSTMENOPAUSAL WOMEN .................................................................................................................................................................. 11 ABSTRACT ........................................................................................................................................................................... 11 INTRODUCTION ................................................................................................................................................................... 13 METHODS ............................................................................................................................................................................. 14 Study Subjects ..................................................................................................................................................................... 14 Measurement of Serum SHBG Concentrations .............................................................................................. 16 Dietary Measurements .................................................................................................................................................... 16 Statistical Analysis ............................................................................................................................................................. 17 RESULTS ............................................................................................................................................................................... 19 DISCUSSION ........................................................................................................................................................................ 22 ACKNOWLEDGMENTS ...................................................................................................................................................... 28 REFERENCES ...................................................................................................................................................................... 30 TABLES .................................................................................................................................................................................. 37 Table 1. Baseline