CoastWatcher
Moderator
SHBG, low testosterone, and type 2 diabetes. It's frequently said that a low SHBG value is a marker for type 2 diabetes - is that really the case? An Australian study examined prospective associations of SHBG and sex steroid levels in a cohort of community dwelling-men (ages ranging from 35-80). Their study questions the association.
- These men were followed for five years with complete SHBG, total testosterone, DHT, estradiol and did not have type 2 diabetes at baseline.
- Diabetes was identified by self-report, fasting glucose measurement, HbA1c, and/or prescriptions for diabetes medications.
- During an average follow-up of 4.95 years, 14.5% of the men developed new type 2 diabetes.
- Multi-adjusted models revealed an inverse association between baseline SHBG, total testosterone, and DHT levels.
- However, SHBG was no longer associated with incident type 2 diabetes after additional adjustment for total testosterone; total testosterone in incident type 2 diabetes, and after separate adjustment for DHT. There was no observed effect of E2 in all models of incident type 2 diabetes.
- CONCLUSIONS: In men, low total testosterone, but not SHBG and other sex steroids, best predicts the development of type 2 diabetes after adjustment for confounders.