SHBG levels in primary infertile men: a critical interpretation in clinical practice

Abstract

<jats:p>Objective: We aimed to test the association between age, body mass index (BMI) and sex hormone-binding globulin (SHBG) in a homogenous cohort of white-European men presenting for primary couple’s infertility. </jats:p> <jats:p>Design: Retrospective study. </jats:p> <jats:p>Methods: Data from 1547 infertile men were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Fasting serum hormones were measured in every patient. Age was considered according to quartile groups (&lt;33, 33-41, &gt;41 years) and BMI as normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2) and obesity (&gt;30 kg/m2). Descriptive statistics and linear regression analysis tested the associations between age, BMI and SHBG. </jats:p> <jats:p>Results: Median SHBG levels increased across quartiles of age and decreased along with BMI increases (all p&lt;0.001). For each year increase in age, SHBG increased 0.32 nmol/l; conversely, for each unit increase in BMI, SHBG decreased by 1.1 nmol/l (all p&lt;0.001). SHBG levels decline with increasing BMI was greater than SHBG progressive increase with age. Overall, BMI explained 3.0 times more of the variability in SHBG than did ageing. At multivariate linear model, age and BMI were the most significant factors influencing SHBG concentration (all p&lt;0.001), after accounting for CCI, albumin levels and smoking status. </jats:p> <jats:p>Conclusions: We found a wide distribution of SHBG concentrations across age and BMI values in primary infertile men. The association between BMI and lowered SHBG levels seems to be greater than the association of ageing with increased SHBG.</jats:p>

The impact of vegetarian diet on sperm quality, sex hormone levels and fertility: a systematic review and meta‐analysis

“…Similar to our analysis, Allen and Key reported a positive correlation between dietary fibre intake and SHBG level, as opposed to a negative correlation between animal fat consumption and SHBG 35 . Also, Boeri et al reported inverse associations between BMI and SHBG levels 94 . It can be interpreted that high‐fibre intake, low‐fat consumption and low BMI levels in vegetarians may lead to higher SHBG levels.…”

“…35 Also, Boeri et al reported inverse associations between BMI and SHBG levels. 94 It can be interpreted that high-fibre intake, low-fat consumption and low BMI levels in vegetarians may lead to higher SHBG levels. The potential role of SHBG in male fertility is inconclusive.…”

Correlation between serum sex hormone-binding globulin levels and nutrition indicators and malnutrition exposure risk in men and postmenopausal women with type 2 diabetes

“…This study has also noted a relationship between elevated serum SHBG levels and an increased risk of malnutrition in men and postmenopausal women with T2DM. Similarly, Boeri et al [ 14 ] discovered an inverse relationship between serum SHBG levels and BMI. The study observed inverse correlations between serum SHBG levels and various nutritional indices, including BMI, serum albumin, prealbumin, and transferrin, with lower levels of serum albumin, prealbumin, and transferrin, alongside higher serum SHBG levels, being indicative of the risk of malnutrition in individuals with T2DM.…”

“…It is known that there are gender-based differences in SHBG expression and premenopausal women experience fluctuations in SHBG levels during the menstrual cycle [ 13 ]. However, recent studies have shown that serum SHBG levels were linked to the nutritional status of individuals with primary infertility [ 14 ], anorexia nervosa [ 15 ], kwashiorkor [ 16 ], and polycystic ovary syndrome [ 17 ]. Notably, SHBG levels are increased in conditions such as anorexia nervosa and kwashiorkor [ 16 ].…”

Research progress on the relationship between sex hormone‐binding globulin and male reproductive system diseases

“…SHBG levels also increase with age; however, evidence indicates that SHBG levels decrease with increasing BMI. The observed negative correlation between BMI and SHBG levels has been reported to be stronger than the association between ageing and increased SHBG levels (Boeri et al, 2020). SHBG level, age and BMI should be considered together while evaluating the severity of male reproductive system diseases so as to improve their predictive role.…”