Background: The relation between sex hormone-binding globulin (SHBG) and vertebral fracture (VFx) is unclear.
Aim: To examine whether SHBG is associated with bone mineral density at lumbar spine (LS-BMD), trabecular bone score (TBS) and prevalent VFx.
Methods: Data of 6224 men and women participants in the third visit of the first cohort (I-3) and the first visit of the second cohort (II-1) of a prospective population based cohort, were available. Serum SHBG and prevalent VFx were assessed at visit I-3 and II-2, whereas LS-BMD and TBS were assessed 4 years later (visits I-4 and II-2). VFx were scored using the Quantitative Morphometry method (QM) and Algorithm Based Qualitative method (ABQ). Multivariate linear and logistic regression models were performed, adjusted for confounding factors such as medication use, lifestyle factors, body mass index, serum glucose, insulin, calcium and phosphate levels.
Results: We identified 854 prevalent VFxQM and 176 prevalent VFxABQ. After correcting for confounders, higher levels of SHBG were associated with lower LS-BMD (3rd tertile vs. 1st tertile: β: -0.04; 95% CIs=-0.06; -0.02) and higher TBS (third tertile vs first tertile: β: 0.02; 95% CIs=0.01; 0.03). Higher levels of SHBG were positively associated with both VFxQM (third tertile vs first tertile: OR: 1.25; 95% CIs=1.02; 1.55) and VFxABQ (third tertile vs first tertile: OR: 2.11; 95% CIs=1.29; 3.5) independent of BMD and TBS. Adjustment for total testosterone and estradiol levels did not affect any of these associations. Also, no sex differences were observed.
Conclusion: This study suggests that SHBG concentration may be a sensitive and early biomarker of VFx. As measurement of serum SHBG is reliable, easy and inexpensive, its assessment may have clinical utility in identifying individuals at high risk of developing VFx later in life that could benefit from effective preventive interventions.
14 May 2016 - 17 May 2016