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SHBG, Bone Mineral Density, and Physical Function Among Injection Drug Users With and Without HIV and HCV
Jenny Pena Dias1, Damani A Piggott1,2, Jing Sun2
1Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
The Journal of Clinical Endocrinology and Metabolism
|March 16, 2022
Summary
Higher sex hormone-binding globulin (SHBG) is linked to HIV and HCV infections. In women, elevated SHBG correlates with reduced physical strength, increased frailty, and lower bone density, but not in men.
Area of Science:
- Endocrinology
- Virology
- Gerontology
Background:
- Sex hormone-binding globulin (SHBG) regulates sex hormone bioavailability and is elevated in individuals with HIV and HCV.
- SHBG is implicated in aging-related conditions like osteoporosis and frailty in the general population.
- The specific relationship between SHBG levels, bone mineral density (BMD), and physical function in people with HIV (PWH) and HCV is not well understood.
Purpose of the Study:
- To investigate the association between chronic HIV and HCV infections and SHBG levels.
- To determine the relationship between SHBG concentrations and low BMD, impaired physical function, and frailty in PWH and HCV.
- To explore potential sex-based differences in these associations.
Main Methods:
- A cross-sectional study involving 278 adults from the AIDS Linked to the IntraVenous Experience cohort, categorized into four groups based on HIV and HCV status.
- Evaluation of SHBG concentrations in relation to grip strength, gait speed, Short Physical Performance Battery scores, Fried Frailty Phenotype, and BMD (lumbar spine, total hip, femoral neck T-scores).
- Adjusted multivariable regression analyses stratified by sex were employed to assess associations.
Main Results:
- SHBG concentrations were higher in women, and in individuals with detectable HIV RNA (>400 copies/mL) and HCV RNA (>15 IU/mL).
- In women, higher SHBG was significantly associated with lower grip strength, increased odds of frailty, and lower lumbar spine BMD.
- These associations between higher SHBG and adverse physical outcomes were not observed in men.
Conclusions:
- Elevated SHBG levels are associated with HIV and HCV viremia.
- Among women, higher SHBG is linked to diminished physical function and lower bone mineral density, suggesting a potential role in accelerated aging.
- Further research is needed to elucidate the biological mechanisms underlying these sex-specific associations.
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