SHBG, Sex Steroids, and Kyphosis in Older Men: The MrOS Study

for the Osteoporotic Fractures in Men (MrOS) Study Research Group

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Accentuated kyphosis is associated with adverse health outcomes, including falls and fractures. Low bone density is a risk factor for hyperkyphosis, and each vertebral fracture adds roughly 4° to forward spine curvature. Sex steroids, in particular low bioavailable estradiol and high sex hormone–binding globulin (SHBG), are associated with bone loss and high SHBG is associated with vertebral fractures in older men. We, therefore, hypothesized that low bioavailable estradiol and high SHBG would be associated with worse kyphosis. To test this hypothesis, we examined the cross-sectional associations between individual bioavailable sex hormones and SHBG with radiographically assessed kyphosis. Participants included 1500 men aged 65 and older from the Osteoporotic Fractures in Men (MrOS) Study, in whom baseline measures of kyphosis and sex hormones were available. Modified Cobb angle of kyphosis, calculated from T4 through T12, was assessed from supine lateral spine radiographs. Serum total estradiol and total testosterone were measured by mass spectrometry, and bioavailable sex steroids were calculated from mass action equations. After adjustment for age and other confounding variables, no association was found between bioavailable estradiol or testosterone and Cobb angle, either when kyphosis was analyzed as a continuous variable or dichotomized into highest versus lower three quartiles. In linear regression models adjusted for age and clinic site, there was a significant association between SHBG and kyphosis (parameter estimate = 0.76 per SD increase, p = 0.01). In the fully adjusted model, this association was weakened and of only borderline statistical significance (parameter estimate = 0.61 per SD, p = 0.05). Logistic models demonstrated similar findings. Although associated with bone loss, we did not demonstrate that low bioavailable estradiol translates into worse kyphosis in older men. High SHBG is associated with bone loss and vertebral fractures. Our results suggest that high SHBG may also be a risk factor for hyperkyphosis.

Original languageEnglish (US)
Pages (from-to)2123-2128
Number of pages6
JournalJournal of Bone and Mineral Research
Volume31
Issue number12
DOIs
StatePublished - Dec 1 2016

Fingerprint

Kyphosis
Globulins
Steroids
Estradiol
Gonadal Steroid Hormones
Bone and Bones
Testosterone
Linear Models
Spine
Osteoporotic Fractures
Confounding Factors (Epidemiology)
Bone Density
Mass Spectrometry
Logistic Models

Keywords

  • AGING
  • HYPERKYPHOSIS
  • SEX STEROIDS
  • SHBG

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine

Cite this

for the Osteoporotic Fractures in Men (MrOS) Study Research Group (2016). SHBG, Sex Steroids, and Kyphosis in Older Men: The MrOS Study. Journal of Bone and Mineral Research, 31(12), 2123-2128. https://doi.org/10.1002/jbmr.2901

SHBG, Sex Steroids, and Kyphosis in Older Men : The MrOS Study. / for the Osteoporotic Fractures in Men (MrOS) Study Research Group.

In: Journal of Bone and Mineral Research, Vol. 31, No. 12, 01.12.2016, p. 2123-2128.

Research output: Contribution to journalArticle

for the Osteoporotic Fractures in Men (MrOS) Study Research Group 2016, 'SHBG, Sex Steroids, and Kyphosis in Older Men: The MrOS Study', Journal of Bone and Mineral Research, vol. 31, no. 12, pp. 2123-2128. https://doi.org/10.1002/jbmr.2901
for the Osteoporotic Fractures in Men (MrOS) Study Research Group. SHBG, Sex Steroids, and Kyphosis in Older Men: The MrOS Study. Journal of Bone and Mineral Research. 2016 Dec 1;31(12):2123-2128. https://doi.org/10.1002/jbmr.2901
for the Osteoporotic Fractures in Men (MrOS) Study Research Group. / SHBG, Sex Steroids, and Kyphosis in Older Men : The MrOS Study. In: Journal of Bone and Mineral Research. 2016 ; Vol. 31, No. 12. pp. 2123-2128.
@article{55760d1cec824478ba58b6d49d4991d9,
title = "SHBG, Sex Steroids, and Kyphosis in Older Men: The MrOS Study",
abstract = "Accentuated kyphosis is associated with adverse health outcomes, including falls and fractures. Low bone density is a risk factor for hyperkyphosis, and each vertebral fracture adds roughly 4° to forward spine curvature. Sex steroids, in particular low bioavailable estradiol and high sex hormone–binding globulin (SHBG), are associated with bone loss and high SHBG is associated with vertebral fractures in older men. We, therefore, hypothesized that low bioavailable estradiol and high SHBG would be associated with worse kyphosis. To test this hypothesis, we examined the cross-sectional associations between individual bioavailable sex hormones and SHBG with radiographically assessed kyphosis. Participants included 1500 men aged 65 and older from the Osteoporotic Fractures in Men (MrOS) Study, in whom baseline measures of kyphosis and sex hormones were available. Modified Cobb angle of kyphosis, calculated from T4 through T12, was assessed from supine lateral spine radiographs. Serum total estradiol and total testosterone were measured by mass spectrometry, and bioavailable sex steroids were calculated from mass action equations. After adjustment for age and other confounding variables, no association was found between bioavailable estradiol or testosterone and Cobb angle, either when kyphosis was analyzed as a continuous variable or dichotomized into highest versus lower three quartiles. In linear regression models adjusted for age and clinic site, there was a significant association between SHBG and kyphosis (parameter estimate = 0.76 per SD increase, p = 0.01). In the fully adjusted model, this association was weakened and of only borderline statistical significance (parameter estimate = 0.61 per SD, p = 0.05). Logistic models demonstrated similar findings. Although associated with bone loss, we did not demonstrate that low bioavailable estradiol translates into worse kyphosis in older men. High SHBG is associated with bone loss and vertebral fractures. Our results suggest that high SHBG may also be a risk factor for hyperkyphosis.",
keywords = "AGING, HYPERKYPHOSIS, SEX STEROIDS, SHBG",
author = "{for the Osteoporotic Fractures in Men (MrOS) Study Research Group} and Woods, {Gina N.} and Huang, {Mei Hua} and Cawthon, {Peggy M.} and Laughlin, {Gail A.} and Schousboe, {John T.} and Corinne McDaniels-Davidson and Cauley, {Jane A.} and Eric Orwoll and Elizabeth Barrett-Connor and Kado, {Deborah M.}",
year = "2016",
month = "12",
day = "1",
doi = "10.1002/jbmr.2901",
language = "English (US)",
volume = "31",
pages = "2123--2128",
journal = "Journal of Bone and Mineral Research",
issn = "0884-0431",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - SHBG, Sex Steroids, and Kyphosis in Older Men

T2 - The MrOS Study

AU - for the Osteoporotic Fractures in Men (MrOS) Study Research Group

AU - Woods, Gina N.

AU - Huang, Mei Hua

AU - Cawthon, Peggy M.

AU - Laughlin, Gail A.

AU - Schousboe, John T.

AU - McDaniels-Davidson, Corinne

AU - Cauley, Jane A.

AU - Orwoll, Eric

AU - Barrett-Connor, Elizabeth

AU - Kado, Deborah M.

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Accentuated kyphosis is associated with adverse health outcomes, including falls and fractures. Low bone density is a risk factor for hyperkyphosis, and each vertebral fracture adds roughly 4° to forward spine curvature. Sex steroids, in particular low bioavailable estradiol and high sex hormone–binding globulin (SHBG), are associated with bone loss and high SHBG is associated with vertebral fractures in older men. We, therefore, hypothesized that low bioavailable estradiol and high SHBG would be associated with worse kyphosis. To test this hypothesis, we examined the cross-sectional associations between individual bioavailable sex hormones and SHBG with radiographically assessed kyphosis. Participants included 1500 men aged 65 and older from the Osteoporotic Fractures in Men (MrOS) Study, in whom baseline measures of kyphosis and sex hormones were available. Modified Cobb angle of kyphosis, calculated from T4 through T12, was assessed from supine lateral spine radiographs. Serum total estradiol and total testosterone were measured by mass spectrometry, and bioavailable sex steroids were calculated from mass action equations. After adjustment for age and other confounding variables, no association was found between bioavailable estradiol or testosterone and Cobb angle, either when kyphosis was analyzed as a continuous variable or dichotomized into highest versus lower three quartiles. In linear regression models adjusted for age and clinic site, there was a significant association between SHBG and kyphosis (parameter estimate = 0.76 per SD increase, p = 0.01). In the fully adjusted model, this association was weakened and of only borderline statistical significance (parameter estimate = 0.61 per SD, p = 0.05). Logistic models demonstrated similar findings. Although associated with bone loss, we did not demonstrate that low bioavailable estradiol translates into worse kyphosis in older men. High SHBG is associated with bone loss and vertebral fractures. Our results suggest that high SHBG may also be a risk factor for hyperkyphosis.

AB - Accentuated kyphosis is associated with adverse health outcomes, including falls and fractures. Low bone density is a risk factor for hyperkyphosis, and each vertebral fracture adds roughly 4° to forward spine curvature. Sex steroids, in particular low bioavailable estradiol and high sex hormone–binding globulin (SHBG), are associated with bone loss and high SHBG is associated with vertebral fractures in older men. We, therefore, hypothesized that low bioavailable estradiol and high SHBG would be associated with worse kyphosis. To test this hypothesis, we examined the cross-sectional associations between individual bioavailable sex hormones and SHBG with radiographically assessed kyphosis. Participants included 1500 men aged 65 and older from the Osteoporotic Fractures in Men (MrOS) Study, in whom baseline measures of kyphosis and sex hormones were available. Modified Cobb angle of kyphosis, calculated from T4 through T12, was assessed from supine lateral spine radiographs. Serum total estradiol and total testosterone were measured by mass spectrometry, and bioavailable sex steroids were calculated from mass action equations. After adjustment for age and other confounding variables, no association was found between bioavailable estradiol or testosterone and Cobb angle, either when kyphosis was analyzed as a continuous variable or dichotomized into highest versus lower three quartiles. In linear regression models adjusted for age and clinic site, there was a significant association between SHBG and kyphosis (parameter estimate = 0.76 per SD increase, p = 0.01). In the fully adjusted model, this association was weakened and of only borderline statistical significance (parameter estimate = 0.61 per SD, p = 0.05). Logistic models demonstrated similar findings. Although associated with bone loss, we did not demonstrate that low bioavailable estradiol translates into worse kyphosis in older men. High SHBG is associated with bone loss and vertebral fractures. Our results suggest that high SHBG may also be a risk factor for hyperkyphosis.

KW - AGING

KW - HYPERKYPHOSIS

KW - SEX STEROIDS

KW - SHBG

UR - http://www.scopus.com/inward/record.url?scp=84999634788&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84999634788&partnerID=8YFLogxK

U2 - 10.1002/jbmr.2901

DO - 10.1002/jbmr.2901

M3 - Article

C2 - 27355438

AN - SCOPUS:84999634788

VL - 31

SP - 2123

EP - 2128

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

IS - 12

ER -