Sex steroids and bone turnover markers in men with symptomatic vertebral fractures
Open accessAbstract
Sex steroids play an important role in the maintenance of bone density in men and women, but the circulating, biologically active unbound fraction is influenced by the concentration of sex hormone binding globulin (SHBG). SHBG increases with advancing age in men and leads to a reduction in serum free testosterone and oestradiol, which may then affect bone turnover, bone mineral density (BMD) and the risk of fractures. We have therefore measured total and unbound sex steroids, SHBG, bone turnover markers and BMD in 57 men with symptomatic low trauma vertebral fractures and 57 age-matched male control subjects. Fasting blood and urine samples were collected from all subjects, who also underwent BMD measurement of the lumbar spine and hip. Serum testosterone, oestradiol, SHBG, bone specific alkaline phosphatase (bone ALP) and urine free deoxypyridinoline/creatinine ratio (fDPD/Cr) were measured. Free sex steroid concentrations were calculated using their ratio with SHBG and albumin and bioavailable testosterone was measured using radioimmunoassay. The two groups were then compared and regression models developed to determine the best predictors of BMD and fracture. Men with vertebral fractures had significantly lower weight and BMD at all sites than control subjects (p<0.0001). Serum total testosterone and oestradiol did not differ between the two groups, but calculated free androgen and free oestradiol indices were lower in the fracture group than the control subjects (p=0.04),…
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Multiple studies report a correlation between SHBG levels and fractures in elderly men.
“Multiple studies report a correlation between SHBG levels and fractures in elderly men as well [153–155].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [155]
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Estrogens and androgens in skeletal physiology and pathophysiology
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- Authors
- Tuck, S. P., Scane, A. C., Fraser, W. D., Diver, M. J., Eastell, R., & Francis, R. M.
- Affiliations
- James Cook University Hospital (GB)
- Royal Liverpool University Hospital (GB)
- Northern General Hospital (GB)
- Newcastle University (GB)
- Corresponding author
- Tuck, S.P.
- Venue
- Bone
- Publisher
- Elsevier BV
- Published
- 2008-12
- Volume
- 43
- Issue
- 6
- Pages
- 999-1005
- ISSN
- 1873-2763 (ISSN-L)
- 8756-3282
- OpenAlex
- W2110668559
- Cited by
- 37
- References
- 7
- Citations by year
- 2025: 1 · 2023: 3 · 2022: 2 · 2021: 2 · 2019: 2 · 2018: 1 · 2017: 3 · 2016: 4 · 2014: 3 · 2013: 3 · 2012: 5
- FWCI
- 2.54
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Bone (publishedVersion)
- PubMed (publishedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Pathology and Forensic Medicine › Vitamin D Research Studies
- Keywords
- sex steroids, sex hormone-binding globulin, vertebral fractures, bone turnover markers, bone mineral density, free testosterone, bone-specific alkaline phosphatase, deoxypyridinoline, underweight, men, osteoporosis, fracture risk, hip bone density, lumbar spine bone mineral density, height loss, age-related bone loss, fragility fractures
- MeSH terms
- Aged, Estradiol, Humans, Insulin-Like Growth Factor I, Male, Middle Aged, Parathyroid Hormone, Sex Hormone-Binding Globulin, Testosterone, Biomarkers, Absorptiometry, Photon, Bone Density, Case-Control Studies, Spinal Fractures, Bone Remodeling
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