Endocrine Abstracts

JOINT1352

Introduction: Sex hormone binding globulins (SHBG) are glycoproteins synthesized in liver, which have high specificity and affinity to bind with sex steroids. Raised levels of SHBG are observed in thyrotoxicosis, hepatic disease, anorexia, growth hormone deficiency and rarely due to oestrogen secreting tumours. Aging and medications (e.g. cytochrome P450 enzyme inducers) are also associated with an increase in SHBG levels.

Objectives: We carried out a retrospective analysis of all the raised SHBG test measurements in men (aged > 18 years), recorded and logged in our University teaching hospital over last 10-years (2014-2024). The primary objective of this observational study was to ascertain possible underlying cause of raised SHBG levels in this cohort apart from registering the final clinical outcome.

Methodology: The existing biochemistry data based was searched for all the raised SHBG test results in men (aged > 18-years) over last 10-years irrespective of their serum testosterone levels. A retrospective analysis of case notes and biochemical & radiological investigation results available on clinical portal was carried out.

Results: We retrieved a list of 123 raised SHBG test results over a period of 10-years in men aged 20-83 years. After excluding the duplication of test results, a total of 45 men (n = 45) were included in the final analysis. Table 1, sums up the key observations of our retrospective study:

Conclusion: Hepatic dysfunction, hyperthyroidism, aging and iatrogenic factors remain well known contributory factors for raised SHBG levels. Oestrogen secreting tumours have been described in literature as rare though important pathology which need to be kept in mind while evaluating men with high SHBG levels. Contrary to what has been described in medical literature, we observed anabolic steroid use associated with raised SHBG levels in 5 of our patients (and the SHBG levels normalized after stopping the anabolic steroids).