Pierre Dürgen, Philip Johann Wölfle, Uta Ceglarek, Jürgen Kratzsch, Wieland Kiess, Mandy Vogel
{"title":"儿童和青少年新的性激素结合球蛋白和估计游离睾酮参考区间：年龄、性别、BMI和口服避孕药的影响","authors":"Pierre Dürgen, Philip Johann Wölfle, Uta Ceglarek, Jürgen Kratzsch, Wieland Kiess, Mandy Vogel","doi":"10.1016/j.cca.2025.120621","DOIUrl":null,"url":null,"abstract":"<p><strong>Context: </strong>Sex-hormone-binding-globulin (SHBG) affects the bioavailability of androgens and estrogens. SHBG is used to calculate free testosterone levels, assess and monitor the hypothalamic-pituitary-gonadal axis, and identify sex-hormone-related diseases in children and adults. However, current pediatric reference intervals for SHBG from large cohort studies are scarce.</p><p><strong>Objective: </strong>We aimed to establish continuous age- and sex-adjusted percentiles for SHBG in children and adolescents and identify influencing factors to support clinical decision-making.</p><p><strong>Design and setting: </strong>We conducted a large, prospective, population-based, open-cohort study in Leipzig, Germany.</p><p><strong>Participants: </strong>SHBG serum levels came from 9702 blood samples (44.97 % female) from 3109 participants aged 0.43 to 18.98 years in the LIFE Child Study.</p><p><strong>Main outcome measures: </strong>We computed associations between SHBG (analyzed with an electrochemiluminescence assay) and potential predictors (BMI, puberty, and liver proteins).</p><p><strong>Results: </strong>SHBG levels declined throughout childhood, starting from approximately 145 nmol/l. The decline steepened at the beginning of puberty until it plateaued at around 15 (in females) or 16 years (in males) with a median of 59.1 nmol/l and 32.0 nmol/l, respectively. SHBG serum levels showed a strong sex-dependent association with age, especially during puberty. In normal-weight and children with obesity, SHBG-SDS values decreased with increasing BMI-SDS (β<sub>NW</sub> = -0.38, p < 0.001; β<sub>OB</sub> = -0.42, p < 0.001). The effect was even stronger in participants with overweight (β<sub>OW</sub> = -1.15, p < 0.001).</p><p><strong>Conclusions: </strong>We present SHBG percentiles for children and adolescents to support diagnoses of sex-hormone-related diseases. Confounders, such as BMI, Tanner stages, and contraceptive use should also be considered when interpreting SHBG measurements. Trial registration number - NCT02550236.</p>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":" ","pages":"120621"},"PeriodicalIF":2.9000,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"New sex hormone-binding globulin and estimated free testosterone reference intervals for children and adolescents: The effects of age, sex, BMI and oral contraceptives.\",\"authors\":\"Pierre Dürgen, Philip Johann Wölfle, Uta Ceglarek, Jürgen Kratzsch, Wieland Kiess, Mandy Vogel\",\"doi\":\"10.1016/j.cca.2025.120621\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Context: </strong>Sex-hormone-binding-globulin (SHBG) affects the bioavailability of androgens and estrogens. SHBG is used to calculate free testosterone levels, assess and monitor the hypothalamic-pituitary-gonadal axis, and identify sex-hormone-related diseases in children and adults. However, current pediatric reference intervals for SHBG from large cohort studies are scarce.</p><p><strong>Objective: </strong>We aimed to establish continuous age- and sex-adjusted percentiles for SHBG in children and adolescents and identify influencing factors to support clinical decision-making.</p><p><strong>Design and setting: </strong>We conducted a large, prospective, population-based, open-cohort study in Leipzig, Germany.</p><p><strong>Participants: </strong>SHBG serum levels came from 9702 blood samples (44.97 % female) from 3109 participants aged 0.43 to 18.98 years in the LIFE Child Study.</p><p><strong>Main outcome measures: </strong>We computed associations between SHBG (analyzed with an electrochemiluminescence assay) and potential predictors (BMI, puberty, and liver proteins).</p><p><strong>Results: </strong>SHBG levels declined throughout childhood, starting from approximately 145 nmol/l. The decline steepened at the beginning of puberty until it plateaued at around 15 (in females) or 16 years (in males) with a median of 59.1 nmol/l and 32.0 nmol/l, respectively. SHBG serum levels showed a strong sex-dependent association with age, especially during puberty. In normal-weight and children with obesity, SHBG-SDS values decreased with increasing BMI-SDS (β<sub>NW</sub> = -0.38, p < 0.001; β<sub>OB</sub> = -0.42, p < 0.001). The effect was even stronger in participants with overweight (β<sub>OW</sub> = -1.15, p < 0.001).</p><p><strong>Conclusions: </strong>We present SHBG percentiles for children and adolescents to support diagnoses of sex-hormone-related diseases. Confounders, such as BMI, Tanner stages, and contraceptive use should also be considered when interpreting SHBG measurements. 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New sex hormone-binding globulin and estimated free testosterone reference intervals for children and adolescents: The effects of age, sex, BMI and oral contraceptives.
Context: Sex-hormone-binding-globulin (SHBG) affects the bioavailability of androgens and estrogens. SHBG is used to calculate free testosterone levels, assess and monitor the hypothalamic-pituitary-gonadal axis, and identify sex-hormone-related diseases in children and adults. However, current pediatric reference intervals for SHBG from large cohort studies are scarce.
Objective: We aimed to establish continuous age- and sex-adjusted percentiles for SHBG in children and adolescents and identify influencing factors to support clinical decision-making.
Design and setting: We conducted a large, prospective, population-based, open-cohort study in Leipzig, Germany.
Participants: SHBG serum levels came from 9702 blood samples (44.97 % female) from 3109 participants aged 0.43 to 18.98 years in the LIFE Child Study.
Main outcome measures: We computed associations between SHBG (analyzed with an electrochemiluminescence assay) and potential predictors (BMI, puberty, and liver proteins).
Results: SHBG levels declined throughout childhood, starting from approximately 145 nmol/l. The decline steepened at the beginning of puberty until it plateaued at around 15 (in females) or 16 years (in males) with a median of 59.1 nmol/l and 32.0 nmol/l, respectively. SHBG serum levels showed a strong sex-dependent association with age, especially during puberty. In normal-weight and children with obesity, SHBG-SDS values decreased with increasing BMI-SDS (βNW = -0.38, p < 0.001; βOB = -0.42, p < 0.001). The effect was even stronger in participants with overweight (βOW = -1.15, p < 0.001).
Conclusions: We present SHBG percentiles for children and adolescents to support diagnoses of sex-hormone-related diseases. Confounders, such as BMI, Tanner stages, and contraceptive use should also be considered when interpreting SHBG measurements. Trial registration number - NCT02550236.
期刊介绍：
The Official Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)
Clinica Chimica Acta is a high-quality journal which publishes original Research Communications in the field of clinical chemistry and laboratory medicine, defined as the diagnostic application of chemistry, biochemistry, immunochemistry, biochemical aspects of hematology, toxicology, and molecular biology to the study of human disease in body fluids and cells.
The objective of the journal is to publish novel information leading to a better understanding of biological mechanisms of human diseases, their prevention, diagnosis, and patient management. Reports of an applied clinical character are also welcome. Papers concerned with normal metabolic processes or with constituents of normal cells or body fluids, such as reports of experimental or clinical studies in animals, are only considered when they are clearly and directly relevant to human disease. Evaluation of commercial products have a low priority for publication, unless they are novel or represent a technological breakthrough. Studies dealing with effects of drugs and natural products and studies dealing with the redox status in various diseases are not within the journal''s scope. Development and evaluation of novel analytical methodologies where applicable to diagnostic clinical chemistry and laboratory medicine, including point-of-care testing, and topics on laboratory management and informatics will also be considered. Studies focused on emerging diagnostic technologies and (big) data analysis procedures including digitalization, mobile Health, and artificial Intelligence applied to Laboratory Medicine are also of interest.
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