Associations of Serum Testosterone and SHBG With Incident Fractures in Middle-aged to Older Men
Authors' conclusion
Low circulating SHBG is strongly associated with a low risk of fracture at all evaluated bone sites, while the associations of circulating T with fracture risk are of lesser magnitude, nonlinear, inconsistent among fracture site, and affected by adjustment for SHBG. These findings demonstrate that circulating SHBG, rather than T, is a major independent biomarker of fracture risk in men. Consequently, both total T and SHBG should be assessed when examining the relationship of endogenous T concentrations with fractures in middle-aged to older men.
Study context
- Population
- Middle-aged to older men, UK Biobank cohort11,088 any fracture cases
- Participants
- 205,973 participants
- Exposure
- Serum testosterone and SHBG and incident fractures
- Outcome
- Incident fractures (any, hip, forearm)
Methodological detailsUK Biobank, Cox regression adjusted for multiple comorbidities/covariates, multiple imputation, cubic splines for nonlinearity
- UK Biobank
- Cox regression adjusted for multiple comorbidities/covariates
- Multiple imputation
- Cubic splines for nonlinearity
Main finding
As reported in the abstract
Hip fracture
0.55
CI 0.47–0.65
Forearm fracture
0.62
CI 0.52–0.74
Observational data: associations, not effects.
Original publication
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