Sex steroids and sex steroid-binding globulin levels amongst middle-aged and elderly men and women from general population

Elif Aribas, Jeanine E. Roeters van Lennep, Yolanda B. De Rijke, Joop S. E. Laven, Mohammad Arfan Ikram, Robin P. Peeters, Maryam Kavousi*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background and Aims Availability of age- and sex-specific reference values for sex steroids and sex steroid-binding globulin (SHBG) levels allows for appropriate interpretation of research findings and their clinical applications. We report the sex-specific distribution and reference levels of sex steroids, including total estradiol, total testosterone and (calculated) free androgen index (cFAI), SHBG and other androgens dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS) and androstenedione across age. Methods Using data from 3291 participants from the prospective population-based Rotterdam Study (2006-2008), we visualised the distribution of sex steroids and SHBG levels by calculating and depicting the 5th, 25th, 50th, 75th and 95th percentiles per year and per age-year across 5-year age bands to provide reference value ranges in men and women. Total estradiol and SHBG were measured using automated immunoassay and androgens using liquid chromatography-mass spectrometry (LC-MS/MS). Result Mean age was 56.8 (range 45.6-79.9) years in men and 56.9 (range 45.7-79.9) years in women. Amongst men, total estradiol and SHBG showed an increasing trend from 45 years onwards. In women, total estradiol and SHBG showed a decreasing trend from 45 years until the age of 60. From 60 years onwards, SHBG showed an increasing trend. For total testosterone, a clear declining trend was observed amongst men but not women. Other androgens showed a similar decreasing trend in both sexes from 45 years onwards. Discussion and Conclusion Our study underlines sex-specific trends in sex steroids and SHBG levels with ageing. This warrants taking into account sex- and age-specific reference values for sex steroids and SHBG when investigating their impact on health outcomes to prevent controversial results and allow for their appropriate clinical application.

Original languageEnglish
Article numbere13866
Number of pages12
JournalEuropean Journal of Clinical Investigation
Issue number12
Early online date29 Aug 2022
Publication statusPublished - Dec 2022

Bibliographical note

Funding Information:
The Rotterdam Study is funded by Erasmus Medical Center and Erasmus University Rotterdam, the Netherlands Organization for the Health Research and Development (ZonMw), the Research Institute for Diseases in the Elderly (RIDE), the Ministry of Education, Culture and Science, the Ministry for Health, Welfare and Sports, the European Commission (DGXII), and the Municipality of Rotterdam. Further support was obtained from the Netherlands Consortium for Healthy Aging and the Dutch Heart Foundation (2012 T008) and the Dutch Cancer Society (NKI‐20157737). This project is further supported by the Gender and Prevention grant (555003017) from ZonMw and Senior Scientist Grant from Dutch Heart Foundation.

Funding Information:
EA, JERL, YBR, MAI, RPP and MK have nothing to disclose. JSEL reports grants from fAstellas (Tokyo, Japan), Dutch Heart Association (Utrecht, the Netherlands), ZonMw (Amsterdam, the Netherlands), personal fees from Titus Healthcare (Hoofddorp, the Netherlands) and grants and personal fees from Ferring (Hoofddorp, the Netherlands), Ansh Labs (Webster, Tx, USA), outside the submitted work.

Publisher Copyright:
© 2022 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.


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