THE ROLE OF SHBG AND SEX HORMONES IN MALE OSTEOPOROSIS

Abstract

Objective: To examine relationship between levels of SHBG, estradiol, testosterone and osteoporosis in men. Subjects and Methods: Cross - Sectional study performed on 44 patients with osteoporosis and 46 subjects without osteoporosis, men aged 50 and over in the Department of the Rheumatology, General internal medicine Clinics and Department of orthopedic, Cho Ray Hospital, from 10/2013 to 04/2014. Diagnosis of osteoporosis by measuring bone mineral density by DXA and criteria of World Health Organization. Data on anthropometry, history of smoking, fracture, alcoholism, sedentary and levels of SHBG, estradiol, testosterone, vitamin D, serum calcium were collected. Result: The distribution of age was similar in the two groups and divided equally for each age group. Results of bivariate analysis: prevalences of low BMI, sedentary, history of fracture in osteoporosis group were higher than non-osteoporotic group (p <0.05). Meanwhile, the study showed no difference in the rates of smoking, alcohol, vitamin D deficiency and low serum calcium in two groups. The level of total testosterone was lower in osteoporosis group compared with non osteoporosis group (p <0.05). SHBG level in osteoporosis group was higher than in non osteoporosis group. The index of the estradiol in osteoporosis tend to be lower than in non osteoporosis, but the difference was not statistically significant. Multivariate analysis: total testosterone level and SHBG level had the largest impact, increasing the risk of osteoporosis 85 times and 12 times when the standard deviation decreased by 1SD and increased by 1SD respectively. Conclusion: The low total testosterone level and high SHBG were an independent risk factors of osteoporosis and did not find an association between estrogen levels and osteoporosis in men after age 50. Key words: osteoporosis, SHBG, testosterone, estradiol, sex hormone, men