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SHBG increase tied to fracture risk in men
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Bone loss and risk for fracture in older men may be predicted by a progressive increase in circulating sex hormone-binding globulin, study data show.
David J. Handelsman, PhD, of the ANZAC Research Institute in Australia, and colleagues evaluated data from the CHAMP cohort on men aged at least 70 years assessed at baseline (2005-2007; n = 1,705), 2-year follow-up (n = 1,367) and 5-year follow-up (n = 958) to determine the relationships between reproductive hormones and changes in bone mineral density and incident fractures, including any, hip or nonvertebral fractures.
At all three time points, serum testosterone, dihydrotestosterone, estradiol and estrone were measured by liquid chromatography-tandem mass spectrometry; and SHBG, luteinizing hormone and follicle-stimulating hormone (FSH) were measured by immunoassay. A well-validated formula was used to calculate free testosterone.
At baseline, 168 participants had any fracture, 137 had nonvertebral fractures and 43 had hip fractures.
In the univariable- and multivariable-adjusted models, changes in serum SHBG, luteinizing hormone, estrone and free testosterone were significantly associated with changes in hip BMD. Serum testosterone was associated with changes in hip BMD in the multivariable-adjusted model only.
In the univariable model, changes in femoral neck BMD over time were associated with progressive temporal changes in serum SHBG, FSH, luteinizing hormone and free testosterone.
Only an increase in SHBG over time was associated with the incidence of any fracture and incidence of hip fracture in the multivariate-adjusted model.
“This is the first study to investigate and report the ongoing dynamic temporal relationship between changes in circulating SHBG levels with concurrent changes in BMD and incident fracture risk in older men,” the researchers wrote. “Men with increasing serum SHBG levels (but not changes in circulating reproductive hormones) over time were more likely to have significant hip bone loss and incident fracture risks at any site or hip. Further longitudinal studies examining temporal changes in circulating SHBG and other major reproductive hormones are warranted to confirm and explain these new findings.” – by Amber Cox
Disclosure: Handelsman reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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