Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/46809
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Type: Journal article
Title: Lower sex hormone-binding globulin is more strongly associated with metabolic syndrome than lower total testosterone in older men: the Health in Men Study
Author: Chubb, P.
Hyde, Z.
Almeida, O.
Flicker, L.
Norman, P.
Jamrozik, K.
Hankey, G.
Yeap, B.
Citation: European Journal of Endocrinology, 2008; 158(6):785-792
Publisher: Bio Scientifica Ltd
Issue Date: 2008
ISSN: 0804-4643
1479-683X
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Responsibility: 
S A Paul Chubb, Zoë Hyde, Osvaldo P Almeida, Leon Flicker, Paul E Norman, Konrad Jamrozik, Graeme J Hankey and Bu B Yeap
Abstract: Reduced circulating testosterone and sex hormone-binding globulin (SHBG) are implicated as risk factors for metabolic syndrome. As SHBG increases with age while testosterone declines, we examined the relative contributions of SHBG and testosterone to the risk of metabolic syndrome in older men.We conducted a cross-sectional study of 2502 community-dwelling men aged > or = 70 years without known diabetes. Metabolic syndrome was defined using the National Cholesterol Education Program-Third Adult Treatment Panel (NCEP-ATPIII) criteria. Early morning fasting sera were assayed for total testosterone, SHBG and LH. Free testosterone was calculated using mass action equations.There were 602 men with metabolic syndrome (24.1%). The risk of metabolic syndrome increased for total testosterone < 20 nmol/l, SHBG < 50 nmol/l and free testosterone < 300 pmol/l. In univariate analyses SHBG was associated with all five components of metabolic syndrome, total testosterone was associated with all except hypertension, and free testosterone was associated only with waist circumference and triglycerides. In multivariate analysis, both total testosterone and especially SHBG remained associated with metabolic syndrome, with odds ratios of 1.34 (95% confidence interval (CI): 1.18-1.52) and 1.77 (95% CI: 1.53-2.06) respectively. Men with hypogonadotrophic hypogonadism (total testosterone < 8 nmol/l, LH < or = 12 IU/l) had the highest prevalence of metabolic syndrome (53%, P<0.001).Lower SHBG is more strongly associated with metabolic syndrome than lower total testosterone in community-dwelling older men. SHBG may be the primary driver of these relationships, possibly reflecting its relationship with insulin sensitivity. Further studies should examine whether measures that raise SHBG protect against the development of metabolic syndrome in older men.
Keywords: Humans; Metabolic Syndrome X; Testosterone; Sex Hormone-Binding Globulin; Multivariate Analysis; Risk Factors; Follow-Up Studies; Prospective Studies; Aged; Aged, 80 and over; Australia; Male
Rights: © 2008 by European Society of Endocrinology
RMID: 0020081069
DOI: 10.1530/EJE-07-0893
Appears in Collections:General Practice publications

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