Abstract
Abnormal sex hormone-binding globulin (SHBG) and sex hormone concentrations are the cause or the consequence of cardiometabolic diseases, however, the clinical correlates of SHBG is clearly less understood. In our study we investigate sex- and age-specific serum SHBG levels and their association with cardiovascular risk (CVR) factors and high-risk conditions in an adult cohort of Italian population. Data from 1176 men and 2236 women, aged 20–81 were analyzed and serum SHBG determined in stored samples using an immunoassay. SHBG concentrations, higher in women than in men in the younger age groups, exhibited a curvilinear increase with age in men and a U-shaped curve across the lifespan in women, with a decrease from the 2nd to the 6th decade of age and an increase after the 6th decade when SHBG concentrations were similar in both sexes. Low SHBG serum levels correlated with the traditional CVR factors diabetes, obesity, and hypertension, whereas high level of SHBG correlated with cholesterol HDL. These associations were more numerous in women than in men, in whom decreased with age. The sex- and age specific differences observed in our population-based cohort should be considered in establishing reference ranges and clinical cut-off points to improve CVR score charts and therapeutic approaches.
Highlights
Sex hormone-binding globulin (SHBG) is a glycoprotein that binds sex steroid hormones and it is produced mainly in the liver
Within the Malattie Aterosclerotiche Istituto Superiore di Sanità (MATISS) study, men and women aged 20–81 years were extracted randomly from a geographical area located in Central Italy about 100 km south of Rome and comprised 4 adjacent rural towns (Sezze, Roccagorga, Bassiano, and Priverno) and examined in 1993–1996 collecting socio-demographic characteristics, lifestyles, risk factors, using standardized procedures and methods [13,14,15]
Results demonstrated that SHBG concentrations in men ranged from a value of 8.5 nm/L to a value of 203.2 nm/L and the mean value increased with age from approximately 32 nm/L in the age groups 20–29 and 30–39 years to 57.1 nm/L in the oldest persons (Table 1 and Figure 1)
Summary
Sex hormone-binding globulin (SHBG) is a glycoprotein that binds sex steroid hormones (testosterone, progesterone and estradiol) and it is produced mainly in the liver. SHBG synthesis are regulated by hormonal and metabolic factors. Several clinical studies have demonstrated the metabolic function of SHBG. Interest in SHBG has escalated in recent years because of its inverse association with metabolic syndrome and type 2 diabetes in women and men [3,4,5,6]. Low SHBG serum were linked with cardiovascular disease in men [7]. Low SHBG serum level in women was associated with poorer cardiovascular health, such endothelial dysfunction, carotid atherosclerosis, and vascular remodeling, greater prevalence of metabolic syndrome, type 2 diabetes, hypertension, the clinical correlates of SHBG in women is less clearly understood [8,9,10]
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