Serum levels of sex hormone‐binding globulin (SHBG) are not associated with lower levels of non‐SHBG‐bound testosterone in male newborns and healthy adult men

Summary Objective It is generally accepted that SHBG decreases the bioavailability and activity of testosterone (T). In in vitro experiments increased levels of SHBG will be associated with decreased levels of non‐SHBG bound testosterone (non‐SHBG‐T). However, in vivo SHBG can alter both production and clearance rates and thus plasma levels of T. Design and patients In order to study the effect of SHBG on the levels of non‐SHBG‐T in vivo in the presence of an active hypothalamo–pituitary–gonadal (HPG) axis we conducted a cross sectional study in 400 healthy adult men with an age range of 40–80 years and in 106 newborn boys. Measurements In both groups, regression coefficients (β) and partial correlation coefficients (r) were calculated for the relationship between SHBG and T or non‐SHBG‐T. Adult men were divided into age groups per decade (40–50 years, 51–60 years, 61–70 years and 71–80 years) to study possible differences in the impact of SHBG on the level of non‐SHBG‐T throughout ageing. Results Higher levels of SHBG were associated with higher levels of total testosterone in neonates (β = 0·02 ± 0·004, r = 0·44, P < 0·001) but not with non‐SHBG‐T (β = −0·001 ± 0·001, r = 0·05, P = 0·52). In adult men there was a significant age related increase in levels of SHBG and an age‐related decrease of both total and non‐SHBG‐T. Higher SHBG was strongly associated with higher total testosterone in all age groups (β = 0·26, 0·26, 0·26 and 0·23 for 40–50 years, 51–60 years, 61–70 years and 71–80 years, respectively, P < 0·001 for all age groups). Higher SHBG was not or only slightly associated with higher non‐SHBG‐T β = 0·02 ( P = 0·32), β = 0·04 ( P = 0·03), β = 0·04 ( P = 0·02) and β = 0·02 ( P = 0·16) for 40–50 years, 51–60 years, 61–70 years and 71–80 years, respectively. Conclusions In contrast to general belief, SHBG levels barely influence levels of non‐SHBG‐bound testosterone both in male newborns and healthy adult men: the influence, if any, is positive. Consequently the age related increase of SHBG does not account for the age related decline in non‐SHBG‐T in healthy adult men.