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. 2016 Mar;31(3):683-9.
doi: 10.1002/jbmr.2718. Epub 2016 Jan 20.

High Serum SHBG Predicts Incident Vertebral Fractures in Elderly Men

Liesbeth Vandenput  1 , Dan Mellström  1   2 , Andreas Kindmark  3 , Helena Johansson  1 , Mattias Lorentzon  1   2 , Jason Leung  4 , Inga Redlund-Johnell  5 , Björn E Rosengren  5 , Magnus K Karlsson  5 , Yi-Xiang Wang  6 , Timothy Kwok  4 , Claes Ohlsson  1
Affiliations

High Serum SHBG Predicts Incident Vertebral Fractures in Elderly Men

Liesbeth Vandenput et al. J Bone Miner Res. 2016 Mar.

Abstract

Previous prospective cohort studies have shown that serum levels of sex steroids and sex hormone-binding globulin (SHBG) associate with nonvertebral fracture risk in men. The predictive value of sex hormones and SHBG for vertebral fracture risk specifically is, however, less studied. Elderly men (aged ≥ 65 years) from Sweden and Hong Kong participating in the Osteoporotic Fractures in Men (MrOS) study had baseline estradiol and testosterone analyzed by gas chromatography-mass spectrometry (GC-MS) and SHBG by immunoradiometric assay (IRMA). Incident clinical vertebral fractures (n = 242 cases) were evaluated in 4324 men during an average follow-up of 9.1 years. In a subsample of these men (n = 2256), spine X-rays were obtained at baseline and after an average follow-up of 4.3 years to identify incident radiographic vertebral fractures (n = 157 cases). The likelihood of incident clinical and radiographic vertebral fractures was estimated by Cox proportional hazards models and logistic regression models, respectively. Neither serum estradiol (hazard ratio [HR] per SD increase = 0.93, 95% confidence interval [CI] 0.80-1.08) nor testosterone (1.05, 0.91-1.21) predicted incident clinical vertebral fractures in age-adjusted models in the combined data set. High serum SHBG, however, associated with increased clinical vertebral fracture risk (1.24, 1.12-1.37). This association remained significant after further adjustment for FRAX with or without bone mineral density (BMD). SHBG also associated with increased incident radiographic vertebral fracture risk (combined data set; odds ratio [OR] per SD increase = 1.23, 95% CI 1.05-1.44). This association remained significant after adjustment for FRAX with or without BMD. In conclusion, high SHBG predicts incident clinical and radiographic vertebral fractures in elderly men and adds moderate information beyond FRAX with BMD for vertebral fracture risk prediction.

Keywords: FRACTURE RISK ASSESSMENT; GENERAL POPULATION STUDIES; MEN; OSTEOPOROSIS; SEX STEROIDS.

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References

    1. Vanderschueren D, Laurent MR, Claessens F, et al. Sex steroid actions in male bone. Endocr Rev. 2014; 35(6):906–60. - PMC - PubMed
    1. Amin S, Zhang Y, Felson DT, et al. Estradiol, testosterone, and the risk for hip fractures in elderly men from the Framingham Study. Am J Med. 2006; 119(5):426–33. - PubMed
    1. Bjornerem A, Ahmed LA, Joakimsen RM, et al. A prospective study of sex steroids, sex hormone‐binding globulin, and non‐vertebral fractures in women and men: the Tromso Study. Eur J Endocrinol. 2007; 157(1):119–25. - PubMed
    1. Mellström D, Vandenput L, Mallmin H, et al. Older men with low serum estradiol and high serum SHBG have an increased risk of fractures. J Bone Miner Res. 2008; 23(10):1552–60. - PubMed
    1. Meier C, Nguyen TV, Handelsman DJ, et al. Endogenous sex hormones and incident fracture risk in older men: the Dubbo Osteoporosis Epidemiology Study. Arch Intern Med. 2008; 168(1):47–54. - PubMed

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