Abstract
BackgroundThe aim of this study was to investigate the association of sex hormone-binding globulin (SHBG) and hypertension in a Swedish population.MethodsThe study is based on a random sample of a Swedish population of men and women aged 30–74 years (n=2,816). Total testosterone, oestradiol and SHBG were measured in 2,782 participants. Free androgen index was then calculated according to the formula FAI=100 × (Total testosterone)/SHBG. Hypertension was diagnosed according to JNC7.ResultsIn men, but not in women, significant association between SHBG and both diastolic (diastolic blood pressure: β=−0.143 p<0.001) and systolic blood pressure (systolic blood pressure β=−0.114 p<0.001) was found. The association was still significant after adjusting for age, body mass index (BMI), homeostatic model assessment insulin resistance (HOMA-IR), triglycerides, high density lipoproteins (HDL) and C-reactive protein (CRP) (diastolic blood pressure: β=−0.113 p<0.001; systolic blood pressure β=−0.093 p=0.001). An inverse association was observed between SHBG and hypertension in both men (B=−0.024 p<0.001) and women (B=−0.022 p<0.001). The association was still significant in women older than 50 years after adjustments for age, BMI, physical activity, CRP and alcohol consumption (B=−0.014, p=0.008).ConclusionIn conclusion, these results show a strong association between SHBG and blood pressure independent of major determinants of high blood pressure. This association might be addressed to direct effects of SHBG in endothelial cells through the receptor for SHBG. If this is confirmed by other observational and experimental studies, it might become a new field for the development of therapies for lowering blood pressure.
Highlights
The aim of this study was to investigate the association of sex hormone-binding globulin (SHBG) and hypertension in a Swedish population
While these results are supported by other authors [18], the role of SHBG in the development of type 2 diabetes is still subject to discussions and its contribution to the development of hypertension has to our knowledge not been investigated at all
A strong negative association between SHBG and body mass index (BMI), fasting plasma glucose, IR-homeostatic model assessment of insulin resistance (HOMA)-IR and TG was found in both men and women and the same was true for systolic and diastolic blood pressure
Summary
The aim of this study was to investigate the association of sex hormone-binding globulin (SHBG) and hypertension in a Swedish population. A sizeable fraction of circulating testosterone is bound to sex hormone-binding globulin (SHBG); it is still not established if the observed link between the total testosterone and several cardiovascular risk factors (atherogenic lipid profile, type 2 diabetes, obesity) mirrors an effect of free circulating testosterone, or whether SHBG plays a more direct role. A recent study by Ding et al [17] showed a strong association of SHBG as well as genes controlling the expression of SHBG with the risk for type 2 diabetes, but not between free testosterone and type 2 diabetes While these results are supported by other authors [18], the role of SHBG in the development of type 2 diabetes is still subject to discussions and its contribution to the development of hypertension has to our knowledge not been investigated at all
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