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J Clin Endocrinol Metab. 2019 Aug 7. pii: jc.2019-01317. doi: 10.1210/jc.2019-01317. [Epub ahead of print]

Higher serum sex hormone-binding globulin (SHBG) levels are associated with incident cardiovascular disease (CVD) in men.

Author information

1
Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.
2
Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, South Australia, Australia.
3
South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia.
4
NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia.
5
Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia.
6
Chemical Pathology, SA Pathology, Adelaide, South Australia, Australia.

Abstract

CONTEXT:

Sex hormone-binding globulin (SHBG) levels are associated with cardiovascular disease (CVD) risk factors. However, prospective data on the association between SHBG levels and CVD events are sparse, with conflicting results.

OBJECTIVES:

To examine associations between serum SHBG, total testosterone (TT), and incident CVD and CVD-related mortality in middle-aged to elderly men.

DESIGN AND METHODS:

Data on 2563 community-dwelling men (35-80 years) were obtained from participants in the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) cohort. The analytic sample included 1492 men without baseline (2002-2007) CVD and with fasted morning serum SHBG and TT available at both baseline and follow-up (2007-2010), and without medications affecting TT or SHBG. Associations of baseline SHBG and TT, with incident CVD and CVD - mortality, were analysed using logistic regression for incident CVD and Cox's proportional hazard regression for CVD mortality, adjusting for established CVD risk factors.

RESULTS:

In multivariable models, elevated baseline SHBG and lower baseline TT were independently associated with incident CVD (OR=1.54 [1.15, 2.06] per SD increase in SHBG, p=0.003) and (OR =0.71 [0.52, 0.97] per SD decrease in TT, p=0.03), respectively. A decrease in TT between time points was associated with incident CVD (OR=0.72 [0.56, 0.92], P=0.01). Neither SHBG nor TT were significantly associated with all-age CVD mortality (HR=0.69 [0.29, 1.63], p=0.40 & HR=0.60 [0.28, 1.26], p=0.18, respectively).

CONCLUSIONS:

Among all men and men aged over 65, both elevated SHBG and lower TT were independently associated with both a greater risk of CVD and an increased CVD mortality risk.

PMID:
31390027
DOI:
10.1210/jc.2019-01317

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