title: The association of testosterone, sex hormone-binding globulin, and insulin-like growth factor-1 with bone parameters in Korean men aged 50 years or older.
abstract: Testosterone and insulin-like growth factor-1 (IGF-1) are essential factors for the maintenance of bone health in men. However, the results for the association of testosterone and IGF-1 with bone parameters were not consistent in prior studies. We evaluated the relationship of testosterone, sex hormone-binding globulin (SHBG), and IGF-1 with bone mineral density (BMD) and bone turnover markers (BTMs) in Korean men. We enrolled 1227 men aged ≥50 years in this cross-sectional study. Serum levels of total testosterone (TT), SHBG, IGF-1, osteocalcin, and C-terminal cross-linking telopeptide of type I collagen (CTX) were measured. Free testosterone (FT) was calculated using Vermeulen's method. BMD was measured by dual-energy X-ray absorptiometry. TT level was not related to BMD or BTMs in the unadjusted model; however, after adjusting for SHBG and IGF-1, the association between TT and BTMs was significant (β = -0.139 for osteocalcin and β = -0.204 for CTX). SHBG levels were negatively associated with lumbar BMD, and positively associated with BTMs in all models. As SHBG level increased, the prevalence of osteopenia or osteoporosis defined by BMD significantly increased (OR of 1SD change, 1.24). IGF-1 levels were significantly related with BMD, but not with BTMs. Meanwhile, FT levels were positively associated with BMD and negatively associated with BTMs. In conclusion, SHBG levels were independently related with bone parameters and osteopenia in men aged ≥50 years. IGF-1 levels were positively associated with BMD, but not with BTMs. SHBG may play a role in regulating age-related bone loss in men after middle-age.
authors.affiliation: Department of Family Medicine, Green-cross I-MED, 06647, Seoul, South Korea.
authors.forename: Hye-Jung
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, Dongguk University Bundang Oriental Hospital, 13601, Seongnam, South Korea.
authors.forename: Hyung Suk
authors.initials: HS
authors.lastname: Koo
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Centre, CHA University, 59 Yatap-ro, Bundang-gu, 13496, Seongnam-Si, Gyeonggi-do, South Korea. zeroup@cha.ac.kr.
authors.forename: Young-Sang
authors.identifier: http://orcid.org/0000-0002-7397-5410
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Centre, CHA University, 59 Yatap-ro, Bundang-gu, 13496, Seongnam-Si, Gyeonggi-do, South Korea.
authors.forename: Moon Jong
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Family Practice and Community Health, School of Medicine, Ajou University, 16499, Suwon, South Korea.
authors.forename: Kwang-Min
authors.initials: KM
authors.lastname: Kim
authors.affiliation: Department of Family Practice and Community Health, School of Medicine, Ajou University, 16499, Suwon, South Korea.
authors.forename: Nam-Seok
authors.initials: NS
authors.lastname: Joo
authors.affiliation: Department of Family Medicine, CHA Bundang Medical Centre, CHA University, 59 Yatap-ro, Bundang-gu, 13496, Seongnam-Si, Gyeonggi-do, South Korea.
authors.forename: Ji-Hee
authors.initials: JH
authors.lastname: Haam
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000502:physiology; D016723:Bone Remodeling; D001842:Bone and Bones / Q000378:metabolism*; D024042:Collagen Type I / Q000097:blood; D003430:Cross-Sectional Studies; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D012044:Regression Analysis; D056910:Republic of Korea; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D013739:Testosterone / Q000097:blood*
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; C583557:IGF1 protein, human; D012738:Sex Hormone-Binding Globulin; D015675:Osteocalcin; D013739:Testosterone; D007334:Insulin-Like Growth Factor I
keywords: Biochemical markers of bone turnover; Bone mineral density; Insulin-like growth factor-1; Sex hormone-binding globulin; Testosterone