title: Evolving utility of sex hormone-binding globulin measurements in clinical medicine.
abstract: OBJECTIVE
  Sex hormone-binding globulin (SHBG) regulates the plasma levels and biological actions of the sex steroids: testosterone and estradiol. Advances in our understanding of how plasma SHBG levels are determined, and how SHBG functions, have provided insight into how SHBG should be used to assess the actions of its sex-steroid ligands, and as a biomarker of metabolic and endocrine abnormalities.
  
  
  RESULTS
  Plasma SHBG levels fluctuate throughout life in response to the changes in metabolic and physiologic states, and are altered by natural hormones and synthetic steroids. Interindividual differences in plasma SHBG levels and activity are also influenced by polymorphisms within the structural and regulatory regions of the SHBG gene.
  
  
  CONCLUSIONS
  Measurements of SHBG are widely used to predict plasma free testosterone levels in patients suffering from excess androgen exposures, but have broader utility in assessing the risk for endocrine diseases and clinical sequelae of the metabolic syndrome, namely, type 2 diabetes and cardiovascular disease. It is anticipated that new genetic and functional data regarding SHBG will reveal whether SHBG is simply a biomarker of these diseases or participants in their cause.
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Child & Family Research Institute, Vancouver, British Columbia, Canada. ghammond@cfri.ca
authors.forename: Geoffrey L
authors.initials: GL
authors.lastname: Hammond
authors.forename: Tsung-Sheng
authors.initials: TS
authors.lastname: Wu
authors.forename: Marc
authors.initials: M
authors.lastname: Simard
mesh_terms: D015415:Biomarkers / Q000097:blood; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000235:genetics / Q000378:metabolism; D011110:Polymorphism, Genetic; D011237:Predictive Value of Tests; D012306:Risk; D017678:Sex Distribution; D012738:Sex Hormone-Binding Globulin / Q000235:genetics / Q000378:metabolism*; D013739:Testosterone / Q000097:blood*
chemical_list: D015415:Biomarkers; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D004958:Estradiol