Sex hormone-binding globulin level may predict liver fibrosis for men with NAFLD
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SAN DIEGO — Higher sex hormone-binding globulin levels may predict liver fibrosis for men with nonalcoholic fatty liver disease, according to a presenter at the AACE Annual Scientific and Clinical Conference.
In a study analyzing a cohort of men with known nonalcoholic fatty liver disease (NAFLD), median SHBG levels were higher among men with a high probability of fibrosis compared with those with an intermediate probability, even though the two groups had a similar mean BMI.
“We usually expect SHBG to be low or low normal in men with NAFLD because they have obesity,” Sandeep Dhindsa, MD, professor of medicine and chief of the division of endocrinology and metabolism at Saint Louis University, told Healio. “However, in men with obesity, NAFLD and advanced fibrosis, SHBG concentrations were high. Thus, SHBG is a biomarker for advanced fibrosis in men with NAFLD. This is important because we currently need an improvement in our capability to noninvasively detect fibrosis in patients with NAFLD.”
Dhindsa and colleagues analyzed data from 64 men with NAFLD recruited from endocrinology and hepatology clinics. Participants underwent FibroScan (Echosens) screening to assess advanced fibrosis. Those with a liver stiffness of less than 7.5 kPa were classified as having a low probability for fibrosis (n = 29; mean age, 47 years; mean BMI, 33 kg/m2), those with liver stiffness between 7.5 kPa and 14 kPa had intermediate fibrosis probability (n = 21; mean age, 46 years; mean BMI, 38 kg/m2),) and those with a liver stiffness higher than 14 kPa had high fibrosis probability (n = 14; mean age, 53 years; mean BMI, 40 kg/m2). Fasting blood samples were collected to measure SHBG.
The FibroScan controlled attenuation parameter score used to measure steatosis was lower in the low fibrosis probability group (322 dB/m) compared with the intermediate probability group (360 dB/m) and the high probability group (350 dB/m). Median SHBG levels were higher in the low fibrosis probability group compared with those with intermediate probability (29 nmol/L vs. 19 nmol/L). The high fibrosis probability group also had higher SHBG concentrations compared with the intermediate probability group (28 nmol/L vs. 19 nmol/L). There were no changes to the associations after adjusting for age, BMI or steatosis.
Dhindsa said more research is needed to further explore the potential utility of SHBG as a predictor for fibrosis.
“SHBG concentrations should be evaluated prospectively in longitudinal follow-up studies of men with NAFLD,” Dhindsa said. “At this time, we do not know if SHBG would be elevated prior to detection of fibrosis with standard noninvasive methods such as FibroScan.”
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Goffinet A, et al. Sex hormone-binding globulin (SHBG) is a marker of liver fibrosis in men with nonalcoholic fatty liver disease (NAFLD). Presented at: American Association of Clinical Endocrinology Annual Scientific and Clinical Conference; May 12-14, 2022; San Diego.
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