Evolving utility of sex hormone-binding globulin measurements in clinical medicine

Abstract

Measurements of SHBG are widely used to predict plasma free testosterone levels in patients suffering from excess androgen exposures, but have broader utility in assessing the risk for endocrine diseases and clinical sequelae of the metabolic syndrome, namely, type 2 diabetes and cardiovascular disease. It is anticipated that new genetic and functional data regarding SHBG will reveal whether SHBG is simply a biomarker of these diseases or participants in their cause.

A Possible Association of Sex Hormone-Binding Globulin with Weight Gain in the Valproic Acid-Treated Female Patients with Epilepsy

“…Second, the influence of the duration and dose of VPA or CBZ therapy, the age, sex, seizure locus, seizure type, seizure control and concomitant use of antiepileptic drugs, including the previous antiepileptic drugs that the patients had used, on the BMI gap may not have been fully excluded, even though we adjusted for several potential confounding factors in the analyses. Regarding age, it has been reported that pre-pubertal males had significantly higher SHBG levels compared with similar-aged pre-pubertal females, and the SHBG levels declined with age in both sexes [10,12]. Third, because we could not obtain any data about the SHBG level before VPA therapy in the present study, we could not clarify whether the association between being overweight and a low SHBG level existed prior to the use of VPA.…”

“…An emerging understanding of the complexity of SHBG synthesis and physiology has led to renewed interest in the potential role of the protein in a wide range of clinical disorders, including metabolic syndrome and type 2 diabetes [8][9][10]. However, there is presently no data available regarding the association between the VPA-induced weight gain and the SHBG level.…”

“…Sex hormone-binding globulin (SHBG) is a glycated homodimeric plasma transport protein that binds testosterone with a higher affinity than estradiol [8][9][10]. An emerging understanding of the complexity of SHBG synthesis and physiology has led to renewed interest in the potential role of the protein in a wide range of clinical disorders, including metabolic syndrome and type 2 diabetes [8][9][10].…”

“…clobazam, gabapentin, topiramate, zonisamide) as covariates, separately in the patients treated with VPA and CBZ (as reference). The interaction between the plasma SHBG levels and sex was also included as a covariate, because the SHBG levels were reported to be affected by the sex of the subject [10,12]. The data on the SHBG levels were converted into log 10 values to ensure the normality of distribution before the multiple linear regression model was employed.…”

Common Variants in the Sex Hormone-Binding Globulin (SHBG) Gene Influence SHBG Levels in Women with Polycystic Ovary Syndrome

“…acts by binding circulating steroid sex hormones, including testosterone and estradiol [10,11] , thereby limiting their target tissue bioavailability [10,12] , and is a key regulator of the steroid-signaling system [13] . Increased free testosterone (FT) results in its peripheral conversion to the potent androgen, dihydrotestosterone, and thus leads to induction of hyperandrogenism [14,15] , a hallmark of PCOS [16,17] .…”