Endogenous Levels of Serum Estradiol and Sex Hormone Binding Globulin Determine Bone Mineral Density, Bone Remodeling, the Rate of Bone Loss, and Response to Treatment with Estrogen in Elderly Women
Abstract
A total of 489 elderly women aged 65-75 yr who participated in a 3-yr, randomized, blinded osteoporosis trial underwent measurements of serum estradiol, bioavailable estradiol, and SHBG. At baseline, bone mineral density (BMD) was lower at the femoral sites (7-19%, P 165 nmol/liter), compared with women in the highest tertiles of total estradiol [>13.3 pg/ml (49 pmol/liter)] and bioavailable estradiol [>4 pg/ml (14 pmol/liter)] or lowest tertile for SHBG (<113 nmol/liter). Bone markers were increased in women in the lowest tertile for serum total estradiol (not significant) and bioavailable estradiol (P < 0.05) and highest tertile for SHBG (P < 0.05). In the longitudinal study, the rate of bone loss in the placebo group was significantly higher in total body (P < 0.05) and spine (P < 0.05) in women in the lowest tertile, compared with the highest tertile of serum bioavailable estradiol. After treatment with conjugated equine estrogens 0.625 mg/d, the increase in BMD was 4-6% higher at the femoral sites (P < 0.05), total body (P < 0.05), and spine (not significant), in the lowest tertile, compared with the highest tertile of serum bioavailable estradiol or highest tertile, compared with the lowest tertile of serum SHBG. In summary, small variations in endogenous serum estradiol and high serum SHBG determine differences in BMD and rate of bone loss in elderly women and also affect the response to treatment with estrogen. Women with a serum estradiol level of less than 9 pg/ml (…
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In women, SHBG levels inversely correlate with BMD at various body sites, ranging from distal radius, proximal femur and greater trochanter to lumbar spine and even the whole body.
“In women on the other hand, SHBG levels inversely correlate with BMD at various body sites, ranging from distal radius, proximal femur and greater trochanter to lumbar spine and even the whole body [157–159].”
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 [159]
Cites
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Prevention and treatment of postmenopausal osteoporosis
Tella, S. H., & Gallagher, J. C. (2014) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/j.jsbmb.2013.09.008 · Cited by 786 · see citing works
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Narinx, N., David, K., Walravens, J., Vermeersch, P., Claessens, F., Fiers, T., Lapauw, B., Antonio, L., & Vanderschueren, D. (2022) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-022-04562-1 · Cited by 96 · see citing works
- Authors
- Rapuri, P. B., Gallagher, J. C., & Haynatzki, G.
- Affiliations
- Creighton University (US)
- Corresponding author
- Rapuri, Prema B.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2004-10
- Volume
- 89
- Issue
- 10
- Pages
- 4954-4962
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2035163399
- Cited by
- 67
- References
- 1
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 4 · 2020: 1 · 2019: 3 · 2018: 1 · 2017: 1 · 2016: 1 · 2015: 4 · 2014: 2 · 2013: 2 · 2012: 2
- FWCI
- 7.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01ag010358-05, 5u01ag010373-08)
- National Institute on Aging (R01AG10358, UO1-AG10373)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
- Keywords
- serum estradiol, sex hormone-binding globulin, bioavailable estradiol, bone mineral density, bone loss, bone remodeling, bone turnover markers, osteoporosis, conjugated equine estrogens, older women, menopause, postmenopausal osteoporosis, femoral bone density, spine bone density
- MeSH terms
- Aged, Estradiol, Female, Humans, Longitudinal Studies, Osteoporosis, Sex Hormone-Binding Globulin, Bone Density, Estrogen Replacement Therapy, Bone Remodeling
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