Association of Sex Hormones and Sex Hormone-Binding Globulin Levels With Bone Mineral Density in Adolescents Aged 12–19 Years

Abstract

BackgroundSex hormones are recognized to play a significant role in increasing bone mineral density (BMD) and promoting bone maturation during adolescence. The purpose of our study was to use a database with large population data to evaluate the association of BMD with sex hormones (including testosterone and estradiol) and sex hormone-binding globulin (SHBG) in adolescent boys and girls aged 12–19 years.MethodsThe data for our study were taken from the National Health and Nutrition Examination Survey 2013-2016, and we used weighted multiple linear regression models to assess the relationship between testosterone, estradiol, and SHBG and total BMD. We use weighted generalized additive models and smooth curve fitting to discover underlying nonlinear relationships.ResultsA total of 1648 teenagers (853 boys, 795 girls) were selected for the final analysis. In boys, testosterone and estradiol levels were positively associated with total BMD, whereas SHBG levels were negatively associated with total BMD after adjusting for covariates [P < 0.05; 95% confidence interval (CI)]. In addition, there was a point between estradiol and total BMD, after which the positive correlation between estradiol and total BMD was relatively insignificant in boys. In girls, there was a positive association between estradiol and total BMD (P < 0.05; 95% CI), but there was no significant association between the testosterone (β 0.0004; 95% CI -0.0001 to 0.0008) or SHBG (β -0.0001; 95% CI -0.0002 to 0.0001) levels and total BMD. We also found an inverted U-shaped association between testosterone and total BMD with the inflection point at 25.4 ng/dL of testosterone.ConclusionsWe found differences in the association of sex hormones with total BMD in boys and girls. Based on our findings, an appropriate increase in serum testosterone levels may be beneficial for skeletal development in girls because of the inverted U-shaped relationship (with the inflection point at 25.4 ng/dL of testosterone), and a high testosterone level might be detrimental to BMD. Furthermore, keeping estradiol levels below a certain level in boys (24.3 pg/mL) may be considered.

Exposure to Trihalomethanes and Bone Mineral Density in US Adolescents: A Cross-Sectional Study (NHANES)

“…Several studies have shown that sex, smoking, diet, and physical activity are strong determinants of adolescent BMD. − In the present study, however, there was no evidence of interaction between THM exposure and physical activity, milk product consumption, and smoking status, suggesting that the effects of THM exposure are independent of these known risk factors. Interestingly, the association of blood Cl-THM concentrations and TBLH BMD z -scores was modified by weight and obesity.…”

Association of blood mercury levels with bone mineral density in adolescents aged 12–19

“…In contrast, a mercury exposure experiment in Girella punctata found that short-term mercury exposure reduced osteoclast activity and may be involved in the protection of osteoblasts (Yachiguchi et al, 2014). As is well known, estrogen de ciency is associated with increased risk of osteoporosis and decreased bone mineral density (Xu et al, 2022;Zhu et al, 2021;Riggs, 2000). Previous studies have found that mercuric chloride can exert estrogen-like effects to regulate the activity of osteoblasts (Suzuki et al, 2004;Wang et al, 2005;Jin et al, 2002).…”

The correlation between high-density lipoprotein cholesterol and bone mineral density in adolescents: a cross-sectional study

“…Ke Xu et al investigated the relationship between gender hormones with BMD value. They demonstrated that the relationship between sex hormones such as testosterone, estradiol, or sex hormone-binding globulin levels and BMD were opposite in the boy and girl subgroups 28 . In summary, sex hormones might be the crucial cause of this association.…”