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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #234241

Title: High Sex Hormone Binding Globulin (SHBG) Levels in Older Patients with Acute Hip Fracture Are Correlated with Worse Function and Increased Bone Resorption

Author
item EGLI, A
item Dawson-Hughes, Bess
item THEILER, R
item STAEHELIN, H
item HENSCHKOWSKI, J
item BISCHOFF-FERRARI, HEIKE

Submitted to: Journal of Bone and Mineral Research
Publication Type: Abstract Only
Publication Acceptance Date: 6/28/2008
Publication Date: 9/12/2008
Citation: Egli, A., Dawson-Hughes, B., Theiler, R., Staehelin, H., Henschkowski, J., Bischoff-Ferrari, H.A. 2008. High Sex Hormone Binding Globulin (SHBG) Levels in Older Patients with Acute Hip Fracture Are Correlated with Worse Function and Increased Bone Resorption. Journal of Bone and Mineral Research. 23(Suppl 1):SU363.

Interpretive Summary:

Technical Abstract: Previous studies suggested that higher SHBG levels are associated with an increased hip fracture risk and that higher testosterone levels may reduce the odds of falling among men and women age 65 and older. The objective of this study is to examine the correlation of serum testosterone and SHBG with function (timed up & go test) and bone resorption (urinary deoxypyridinolin = DPD) within 1 to 2 weeks after hip fracture surgery. The mean baseline age for participants was 86 year (+/- 6.9), 79% women, and 69% were admitted from home. This baseline data is from the ongoing Zurich hip fracture trial with vitamin D including 173 patients with acute hip fracture. Total testosterone serum levels were above the laboratory detection threshold (> 0.1 nmol/l) in 33 of 36 men and in 57 of 135 women. Mean total testosterone levels were 5.16 (+/- 4.51) nmol/l in men and 0.60 (+/- 0.41) nmol/l in women. We did not find significant univariate correlations between total testosterone and function or DPD in men or women. Mean serum SHBG levels were 47.9 (+/-17.4) nmol/l in men and 58.4 (+/- 20.0) nmol/l in women. Among men and women, higher SHBG levels correlated with slower performance in the timed up&go test (men: r = 0.49, p = 0.01; women: r = 0.35, p < 0.0001). Similarly, higher SHBG levels were correlated with higher urinary DPD excretion in men (r = 0.37, p = 0.03) and women (r= 0.18, p = 0.02). In the multivariate model, a higher SHBG level was significantly associated with slower performance in the timed up&go test (p = 0.001) independent of age, gender, type of dwelling, serum 25(OH)D level, and body mass index. Apart from SHBG level, only female gender was associated with slower test performance (0.03). Furthermore, in the second multivariate model, a higher SHBG level was significantly associated with higher DPD excretion (p = 0.03) independent of age, gender, type of dwelling, serum 25(OH)D level, and body mass index. Adding testosterone to both multivariate models did not change significance of SHBG and testosterone had no independent effect. In conclusion, higher SHBG levels in patients with acute hip fracture are independently associated with worse function and increased bone resorption during acute care after hip fracture surgery. Total testosterone levels were low in men with acute hip fracture, and did not correlate with function or DPD excretion in men or women early after hip fracture surgery.