Osteoporosis in men: a potential role for the sex hormone binding globulin
Abstract
The exact mechanism of bone loss remains unknown in primary male osteoporosis. It has been suggested that estrogen and sex hormone binding globulin (SHBG) play a role in regulating bone turnover and bone mass in healthy men > 65 years of age. In the present study, 80 men (mean age 49.7 years) with bone mineral density >2.5 SD below the young adult value and 40 age-matched controls were recruited to evaluate the relationships between sex hormone levels, bone biochemical markers levels, and bone mineral density. Fasting serum samples were assayed for total and free testosterone total estradiol, and SHBG. The free androgen index, was calculated as: [total testosterone/SHBG * 100]. Bone remodeling was evaluated by measurement of urinary levels of the C-telopeptide of type I collagen (CTx) and free deoxypyridinoline (D-Pyr), serum osteocalcin, and bone-specific alkaline phosphatase (bSAP). There was no significant difference between controls and osteoporotic men according to age, body mass index (BMI), total testosterone, and estradiol. In contrast, serum SHBG level was significantly higher (+42.2%), whereas free androgen index was lower (-24.8%) in patients with primary or secondary osteoporosis. Testosterone and estradiol levels did not correlate with any bone resorption or bone formation markers. In contrast, stepwise linear regression analysis showed that SHBG was significantly correlated with D-Pyr (r = 0.45, p < 0.05) and CTx (r = 0.34, p < 0.05) in primary osteoporosis. In…
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Associations between total T levels and low bone density have been reported, but results are conflicting.
“Interestingly, associations between total T levels and low bone density have been reported, but results are conflicting [146, 160–162].”
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 [146]
SHBG correlates, in both sexes, with an increase in bone resorption markers such as C-telopeptide of type I collagen and N-telopeptides, reflecting greater bone loss.
“SHBG also correlates, in both sexes, with an increase in bone resorption markers such as C-telopeptide of type I collagen and N-telopeptides, reflecting greater bone loss [146, 149].”
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 [146]
For free T, lower values were reported in association with secondary osteoporosis, while another study could not confirm an association with BMD.
“For free T, lower values were reported in association with secondary osteoporosis [146], while another study could not confirm an association with BMD [160].”
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 [146]
In men, bone mineral density at the greater trochanter, femoral neck and the lumbar spine is negatively correlated with concentrations of SHBG.
“Moreover, in men, bone mineral density (BMD) at the greater trochanter, femoral neck and the lumbar spine is negatively correlated with concentrations of SHBG [146, 150–152].”
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 [146]
A higher serum SHBG was observed in male patients suffering from primary or secondary osteoporosis.
“A higher serum SHBG was observed in male patients suffering from primary or secondary osteoporosis [146–148].”
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 [146]
Cites
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Estrogens and androgens in skeletal physiology and pathophysiology
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Plasma steroid-binding proteins: primary gatekeepers of steroid hormone action
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- Authors
- Legrand, E., Hedde, C., Gallois, Y., Degasne, I., Boux de Casson, F., Mathieu, E., Baslé, M.-F., Chappard, D., & Audran, M.
- Affiliations
- Centre Hospitalier Universitaire d'Angers (FR)
- ORCID
- Chappard, D
- Venue
- Bone
- Publisher
- Elsevier BV
- Published
- 2001-07
- Volume
- 29
- Issue
- 1
- Pages
- 90-95
- ISSN
- 1873-2763 (ISSN-L)
- 8756-3282
- OpenAlex
- W1988804459
- Cited by
- 127
- References
- 1
- Citations by year
- 2025: 2 · 2023: 6 · 2022: 3 · 2021: 5 · 2020: 2 · 2019: 4 · 2018: 4 · 2017: 3 · 2016: 5 · 2015: 4 · 2014: 6 · 2013: 5 · 2012: 5
- FWCI
- 5.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Bone (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Keywords
- sex hormone-binding globulin, bone mineral density, secondary osteoporosis, primary osteoporosis, free androgen index, testosterone, estradiol, bone turnover markers, deoxypyridinoline, C-terminal telopeptide of type I collagen, bone-specific alkaline phosphatase, osteocalcin, vertebral fractures, bone loss
- MeSH terms
- Adult, Estradiol, Humans, Male, Middle Aged, Osteoporosis, Sex Hormone-Binding Globulin, Testosterone, Biomarkers, Bone Density, Case-Control Studies, Spinal Fractures, Bone Remodeling
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