Testosterone, sex hormone-binding globulin and risk of cardiovascular events: A report from the Outcome Reduction with an Initial Glargine Intervention trial

Wang, Anne; Arver, Stefan; Boman, Kurt; Gerstein, Hertzel C.; Lee, Shun Fu; Hess, Sibylle; Rydén, Lars; Mellbin, Linda

doi:10.1177/2047487318819142

Cited by 13 publications

(4 citation statements)

References 133 publications

(239 reference statements)

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“… 21 On the one hand, it can specifically bind to sex hormones and participate in their transport. 22 On the other hand, it can regulate the concentration of biologically active sex hormones in the blood. SHBG has high binding power with testosterone.…”

Section: Discussionmentioning

confidence: 99%

Association of free androgen index and sex hormone–binding globulin and left ventricular hypertrophy in postmenopausal hypertensive women

Chen

Wang

Pei

et al. 2021

J of Clinical Hypertension

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The aim of the present study was to explore the relationship between androgen and LVH in postmenopausal hypertensive women. Enrolled in this study were 378 postmenopausal hypertensive women who were admitted to the department of cardiology between December 2018 and December 2020. According to left ventricular mass index (LVMI) evaluated by echocardiography, the patients were divided into LVH group (n = 172) and non‐LVH group (n = 206). Their clinical characteristics were collected. Based on the result of propensity score matching analysis, 160 cases in each group were matched successfully. After correcting for confounding factors by various models, the results showed that free androgen index (FAI) and sex hormone–binding globulin (SHBG) were the influencing factors of LVH in postmenopausal women with hypertension. Patients with elevated SHBG were 5% less likely to develop LVH than those without elevated SHBG (OR: 0.950, 95% CI 0.922‐1.578). Postmenopausal hypertensive patients with elevated FAI were 16% more likely to have LVH than those without elevated FAI (OR: 1.608, 95% CI 0.807‐3.202). Multiple linear regression showed that LVMI increased by 61.82g/m2 for every 1 unit increase in FAI. In addition, SHBG decreased by 1 nmol/l, and LVMI increased by 0.177g/m2. Subgroup analysis showed that patients in the controlled BP group had a lower risk of LVH for every additional unit of SHBG compared with the uncontrolled BP group. The risk of LVH for each additional unit of FAI in the uncontrolled BP group was higher than that in the controlled BP group. The results of this present study showed that the occurrence of LVH was positively correlated with FAI and negatively correlated with SHBG in postmenopausal women with hypertension. The increase in FAI level and the decrease in SHBG level may be related to the occurrence and development of LVH in postmenopausal hypertension.

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Section: Discussionmentioning

confidence: 99%

Association of free androgen index and sex hormone–binding globulin and left ventricular hypertrophy in postmenopausal hypertensive women

Chen

Wang

Pei

et al. 2021

J of Clinical Hypertension

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“…1,2 Given the limited discriminative ability of these approaches, 3 several additional non-circulating and circulating biomarkers have been examined as means of refining risk stratification, with potentially promising results. 4,5 These biomarkers include high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble urokinase plasminogen activator receptor (suPAR). 6–11 Accordingly, the aim of this study was to examine whether these three circulating biomarkers carried incremental prognostic value in predicting cardiovascular events beyond traditional cardiovascular risk factors in apparently healthy individuals.…”

Section: Introductionmentioning

confidence: 99%

Circulating biomarkers for long-term cardiovascular risk stratification in apparently healthy individuals from the MONICA 10 cohort

Frary

Blicher

Olesen

et al. 2019

Eur J Prev Cardiolog

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Aims The aim of this study was to examine whether high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble urokinase plasminogen activator receptor (suPAR) carried incremental prognostic value in predicting cardiovascular morbidity and mortality beyond traditional risk factors in apparently healthy individuals. Methods and results This was a prospective population-based cohort study comprising 1951 subjects included in the 10-year follow-up of the MONItoring of trends and determinants in CArdiovascular disease (MONICA) study, between 1993 and 1994. The principal endpoint was death from cardiovascular causes. Secondary endpoints were death from any cause, coronary artery disease, heart failure, and cerebrovascular disease. Predictive capabilities of each of the three biomarkers were tested using Cox proportional-hazards regression, Harrell’s concordance index (C-index), and net reclassification improvement (NRI). Study participants were aged 41, 51, 61, or 71 years, and equally distributed between the two sexes. During a median follow-up of 18.5 years (interquartile range: 18.1–19.0), 177 (9.1%) subjects died from a cardiovascular cause. Hs-CRP (adjusted standardized hazard ratio (HR): 1.37, 95% confidence interval (CI): 1.17–1.60), NT-proBNP (HR: 1.90, 95% CI: 1.58–2.29), and suPAR (HR: 1.35, 95% CI: 1.17–1.57) were all significantly associated with cardiovascular deaths after adjustment for age, sex, smoking status, systolic blood pressure, and total cholesterol ( p < 0.001 for all). Furthermore, all three biomarkers were significantly associated with significant NRI. However, only NT-proBNP significantly raised the C-index in predicting death from cardiovascular causes when added to the risk factors (C-index 0.860 versus 0.847; p = 0.02). Conclusions Hs-CRP, suPAR, and particularly NT-proBNP predicted cardiovascular death and may enhance prognostication beyond traditional risk factors in apparently healthy individuals.

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“…In addition, a study showed that SHBG could predict cardiovascular events [hazard ratio (HR) = 1.07, 95% CI = 1.00 to 1.14), p = 0.03] and all-cause mortality (HR = 1.13, 95% CI = 1.06 to 1.21, p < 0.01) in males at high risk of CVD. 64 Therefore, we conducted subgroup analyses according to mean or quartile of age and BMI to explore the factors that might influence the difference in SHBG level between the moderate-severe and mild groups. The results showed that when the age was more than 50 years, the SHBG levels of the moderate-severe group were lower than those of the mild group; when the BMI was over 27 kg/m 2 , the SHBG level of the moderate-severe group was higher than that of the mild group.…”

Section: Discussionmentioning

confidence: 99%

Relationship between total testosterone, sex hormone–binding globulin levels and the severity of non-alcoholic fatty liver disease in males: a meta-analysis

Huang

Yang

et al. 2022

Therapeutic Advances in Endocrinology

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Background: In recent years, many studies have reported the relationship between non-alcoholic fatty liver disease (NAFLD) and sex hormones, especially total testosterone (TT) and sex hormone–binding globulin (SHBG). However, the relationship between sex hormones and the severity of NAFLD is still unclear. Methods: PubMed, Embase, Cochrane Library, Web of Science, WanFang, China National Knowledge Infrastructure and VIP databases were searched for relevant studies from inception to 31 August 2021. Values of weighted mean differences (WMDs) and odds ratios (ORs) with their 95% confidence intervals (CIs) were combined by Stata 12.0 software to evaluate the relationship between TT, SHBG and the severity of NAFLD in males. Results: A total of 2995 patients with NAFLD from 10 published cross-sectional studies were included for further analysis. The meta-analysis indicated that the moderate-severe group had a lower TT than the mild group in males with NAFLD (WMD: −0.35 ng/ml, 95% CI = −0.50 to −0.20). TT and SHBG were important risk factors of moderate-severe NAFLD in males (ORTT = 0.79, 95% CI = 0.73 to 0.86; ORSHBG = 0.22, 95% CI = 0.12 to 0.39; p < 0.001). Moreover, when the analysis was limited to men older than age 50, SHBG levels were lower in those with moderate-severe disease (WMD: −11.32 nmol/l, 95% CI = −14.23 to −8.40); while for men with body mass index (BMI) >27 kg/m2, moderate-severe NAFLD had higher SHBG levels than those with mild disease (WMD: 1.20 nmol/l, 95% CI = −2.01 to 4.42). Conclusion: The present meta-analysis shows that lower TT is associated with the severity of NAFLD in males, while the relationship between SHBG and severity of NAFLD is still to be further verified.

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Testosterone, sex hormone-binding globulin and risk of cardiovascular events: A report from the Outcome Reduction with an Initial Glargine Intervention trial

Cited by 13 publications

References 133 publications

Association of free androgen index and sex hormone–binding globulin and left ventricular hypertrophy in postmenopausal hypertensive women

Association of free androgen index and sex hormone–binding globulin and left ventricular hypertrophy in postmenopausal hypertensive women

Circulating biomarkers for long-term cardiovascular risk stratification in apparently healthy individuals from the MONICA 10 cohort

Relationship between total testosterone, sex hormone–binding globulin levels and the severity of non-alcoholic fatty liver disease in males: a meta-analysis

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