SHBG: Is it Really A Marker for Diabetes?

CoastWatcher · Jul 14, 2018

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.

"The role of sex hormone-binding globulin (SHBG), testosterone, and other sex steroids, on the development of type 2 diabetes in a cohort of community-dwelling middle-aged to elderly men," Acta Diabetalogica, August 2018, https://link.springer.com/article/10.1007/s00592-018-1163-6

Vince · Jul 14, 2018

CoastWatcher, I know you have low shbg, what does your A1C run at?

CoastWatcher · Jul 14, 2018

Vince said:
CoastWatcher, I know you have low shbg, what does your A1C run at?

I am due for labs. Last time it was measured it came in at 5.3.

Vince Carter · Jul 14, 2018

I've never pulled A1C, my other Drs won't as my fasting glucose is always under the lab range so they say it's not necessary, and I believe them. Now, this whole low SHBG and (pre) diabetes thing I think it's all hogwash. Of all my time on the forums there's not be one single guy that corrected some diabetic condition that raised his SHBG. In isolation like that. Besides, high SHBG isn't demonized in the same manner, not even close. In fact you get no mention at all of these non-medical "conditions", like pre-diabetes or metabolic syndrome, when some one says high SHBG.

CoastWatcher · Jul 14, 2018

Vince Carter said:
I've never pulled A1C, my other Drs won't as my fasting glucose is always under the lab range so they say it's not necessary, and I believe them. Now, this whole low SHBG and (pre) diabetes thing I think it's all hogwash. Of all my time on the forums there's not be one single guy that corrected some diabetic condition that raised his SHBG. In isolation like that. Besides, high SHBG isn't demonized in the same manner, not even close. In fact you get no mention at all of these non-medical "conditions", like pre-diabetes or metabolic syndrome, when some one says high SHBG.

It's never been drummed as loudly here at EM as it has been at other Forums, one in particular. In my doctor's practice, she once said (I know - an anecdotal account is about to follow) that while she certainly has diabetic patients, she sees none of her low SHBG patients moving into diabetes unless they are engaged in activities that might well lead anyone toward diabetes.