Associations of serum sex hormone-binding globulin and sex hormone concentrations with hip fracture risk in postmenopausal women

Jennifer S. Lee, Andrea Z. Lacroix, Lieling Wu, Jane A. Cauley, Rebecca D. Jackson, Charles Kooperberg, Meryl S. Leboff, John A Robbins, Cora E. Lewis, Douglas C. Bauer, Steven R. Cummings

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

Context: Endogenous estradiol, testosterone, and SHBG may influence the risk of hip fracture. Design and Methods: From the Women's Health Initiative Observational Study, 39,793 eligible postmenopausal women did not have a previous hip fracture and were not using estrogen or other bone-active therapies. Of these, 400 who had a first-time nonpathological hip fracture (median follow-up, 7 yr) were matched to 400 controls by age, ethnicity, and baseline blood draw date. Estradiol, testosterone, and SHBG were measured in banked baseline serum. Results: Compared with women in the lowest tertiles, those with bioavailable testosterone in the highest tertile had a lower risk [odds ratio (OR) = 0.62; 95% confidence interval (CI) = 0.44-0.88]; those with bioavailable estradiol in the highest tertile had a lower risk (OR = 0.44; 95% CI = 0.29-0.66), and those with SHBG in the highest tertile had a higher risk (OR = 1.90; 95% CI = 1.31-2.74) of hip fracture. In models with all three hormones and potential confounders, high SHBG remained a strong independent risk factor (OR = 1.76; 95% CI = 1.12-2.78), high bioavailable testosterone remained protective (OR = 0.64; 95% CI = 0.40-1.00), but estradiol no longer was associated (OR = 0.72; 95% CI = 0.42-1.23). Conclusions: High serum SHBG is associated with an increased risk of subsequent hip fracture and high endogenous testosterone with a decreased risk, independent of each other, serum estradiol concentration, and other putative risk factors. But endogenous estradiol has no independent association with hip fracture.

Original languageEnglish (US)
Pages (from-to)1796-1803
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume93
Issue number5
DOIs
StatePublished - May 2008

    Fingerprint

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Lee, J. S., Lacroix, A. Z., Wu, L., Cauley, J. A., Jackson, R. D., Kooperberg, C., Leboff, M. S., Robbins, J. A., Lewis, C. E., Bauer, D. C., & Cummings, S. R. (2008). Associations of serum sex hormone-binding globulin and sex hormone concentrations with hip fracture risk in postmenopausal women. Journal of Clinical Endocrinology and Metabolism, 93(5), 1796-1803. https://doi.org/10.1210/jc.2007-2358