SHBG and total testosterone levels in men with adult onset hypogonadism: what are we overlooking?

Clinical Diabetes and Endocrinology

Stephen J. Winters¹ 

[1] Division of Endocrinology, Metabolism and Diabetes, University of Louisville, ACB-A3G11, 550 Jackson Street, 40202, Louisville, KY, USA;

关键词: SHBG;    Testosterone;    Male hypogonadism;    Metabolic syndrome;   

DOI  :  10.1186/s40842-020-00106-3

来源: Springer

【 摘 要 】

BackgroundAdult onset male hypogonadism (AOH) is a common clinical condition whose diagnosis and management are controversial, and is often characterized by a low level of SHBG, but our understanding of why testosterone levels are low when SHBG is low is incomplete.MethodsThis retrospective chart review was performed to compare the relationship between SHBG and testosterone in the plasma of men presenting for evaluation of AOH with a cohort of men treated chronically with transdermal testosterone.ResultsThe level of SHBG was < 30 nmol/L in 73% of men who presented for evaluation of AOH, and was inversely proportional to BMI in both the untreated and the testosterone-treated men. As in previous populations, the level of SHBG was highly positively correlated (r = 0.71, p < 0.01) with the total testosterone level in untreated men presenting for evaluation of AOH, but no relationship was found between the level of SHBG and total testosterone among men who were being treated with a transdermal testosterone preparation.ConclusionsThese findings further support the idea that SHBG regulates testicular negative feedback either directly or by modulating the entry of testosterone or estradiol into cells in the hypothalamus and/or pituitary to control gonadotropin synthesis and secretion which explains in part the low testosterone levels in men with AOH.Trial registrationNot applicable

【 授权许可】

CC BY