Aribas Elif, Roeters van Lennep Jeanine E, De Rijke Yolanda B, Laven Joop S E, Ikram Mohammad Arfan, Peeters Robin P, Kavousi Maryam
Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Eur J Clin Invest. 2022 Dec;52(12):e13866. doi: 10.1111/eci.13866. Epub 2022 Sep 8.
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.
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).
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.
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.
提供按年龄和性别划分的性激素及性激素结合球蛋白（SHBG）水平的参考值，有助于对研究结果及其临床应用进行恰当解读。我们报告了性激素的性别特异性分布及参考水平，包括总雌二醇、总睾酮和（计算得出的）游离雄激素指数（cFAI）、SHBG以及其他雄激素，如脱氢表雄酮（DHEA）、硫酸脱氢表雄酮（DHEAS）和雄烯二酮在各年龄段的情况。
利用基于鹿特丹前瞻性人群研究（2006 - 2008年）中3291名参与者的数据，我们通过计算并描绘每年及每岁年龄段在5岁年龄组中的第5、25、50、75和95百分位数，来直观呈现性激素和SHBG水平的分布情况，从而提供男性和女性的参考值范围。总雌二醇和SHBG采用自动免疫分析法测定，雄激素采用液相色谱 - 质谱联用（LC - MS/MS）法测定。
男性的平均年龄为56.8岁（范围45.6 - 79.9岁），女性为56.9岁（范围45.7 - 79.9岁）。在男性中，总雌二醇和SHBG从45岁起呈上升趋势。在女性中，总雌二醇和SHBG从45岁至60岁呈下降趋势。从60岁起，SHBG呈上升趋势。对于总睾酮，在男性中观察到明显的下降趋势，而在女性中未观察到。其他雄激素在两性中从45岁起均呈现类似的下降趋势。
我们的研究强调了性激素和SHBG水平随年龄增长的性别特异性趋势。在研究它们对健康结果的影响时，考虑性激素和SHBG的性别及年龄特异性参考值，以避免有争议的结果并实现其恰当的临床应用，这一点很有必要。
