A liquid-phase immunoradiometric assay (IRMA) for human sex hormone binding globulin (SHBG)

Maternal hormone levels in early gestation of cryptorchid males: a case-control study

A case-control study was conducted to assess maternal hormonal factors associated with increased risk of bearing a cryptorchid son. Serum samples were collected during the first trimester of pregnancy from participants in the US Collaborative Perinatal Study. Twenty-five mothers of normal offspring (controls) were individually matched on medical center, age, parity, weight and length of gestation at the time of sampling to women bearing sons who had a diagnosis of cryptorchidism at one year of age or older. Compared with controls, mothers of cryptorchid sons (cases) had significantly greater percentages of non-protein bound (P = 0.010) and albumin-bound (P = 0.014) estradiol during the first trimester of the index pregnancy. On average, cases had 16% more bioavailable oestradiol than controls. Levels of human chorionic gonadotropin, testosterone, non-protein bound testosterone and sex-hormone binding globulin did not differ between the two groups. The data presented support the hypothesis that cryptorchidism results from elevated maternal oestrogen levels early in pregnancy.

A novel two-site immunoradiometric assay for beta-endorphin using nitrocellulose as solid phase

A two-site immunoradiometric assay for the highly specific direct quantitation of nonacetylated beta h-EP in crude brain tissue samples has been developed with a detection limit of 10 fmol per well. The assay used two different antibodies with distinct specificities: a polyclonal rabbit anti-beta h-EP antibody binding between the middle portion and the C-terminal end of beta h-EP was bound to nitrocellulose membrane discs, a solid phase with a high protein binding capacity. In the following two incubation steps, the beta h-EP containing crude tissue extract--or the beta h-EP-standard--and, subsequently, the 125I-labeled monoclonal 3-E7 mouse antibody directed against the N-terminus of beta h-EP were added. Binding of beta h-EP to the solid phase antibody in the first incubation step was not affected by the addition of cross reacting opioid peptides derived from beta h-LPH up to 10 pmol per disc. Nonspecific binding of the labeled antibody to the solid phase could be lowered to 3% of total counts by the use of PBS containing nonfat dry milk as blocking solution and incubation buffer, a procedure that did not reduce maximum specific binding. Dilution studies performed with extracts sampled from the anterior hypothalamus excluded the interference of tissue factors in the assay.

Sex hormone-binding globulin and the natural history of breast cancer

Low concentrations of SHBG in the blood appear to be related to rapid tumour growth rates whereas normal values are associated with slower rates. The inferences drawn from these and other experimental results are as follows: 1. It is no longer necessary to postulate that an abnormal endocrine environment is related to the risk of breast cancer. 2. Variation within the normal range of endocrine function may be sufficient to account for marked differences in the growth rates of transformed cells. 3. It is suggested that women whose tumours arise in an environment characterised by SHBG concentrations at the lower end of the normal range (and, hence, non-SHBG-bound oestradiol levels at the top end of the range) will tend to have an earlier age at diagnosis, a lower frequency of oestrogen-receptor positive tumours and a lower proportion of hormone responsive tumours than women with SHBG levels at the top of the range. 4. Case/control studies in which growth rates are not taken into account may be difficult to interpret.

Evaluation of an immunoassay for plasma sex hormone-binding globulin: comparison with steroid-binding assay under physiological and pathological conditions

It is possible that alterations in sex hormone-binding globulin (SHBG) binding capacity are due to changes in binding kinetics rather than changes in concentration and, therefore, the immunoreactivity of SHBG may not reflect the binding activity. In this study an immunoradiometric (IRMA) assay was evaluated and the results compared with those of an established binding capacity assay. The correlation between the results of the IRMA (y) and binding assay (x) for 179 specimens was r = 0.984, y = 0.95x + 5.9. Irrespective of the method used, SHBG values in normal non-pregnant women were significantly (P less than 0.05) higher than those in normal men, hirsute women, women with polycystic ovary syndrome, hyperprolactinaemic women and obese women, and were significantly less than those in pregnant women; SHBG levels in hirsute women rose during treatment with certain anovulants and fell in genetic males during the second decade of life independent of androgen levels or activity. While being technically simpler SHBG-IRMA provides comparable results to the classical binding assay, indicating that immunoreactivity is an excellent index of binding activity.

A simple enzyme-linked immunosorbent assay for sex hormone-binding globulin

A simple enzyme-linked immunosorbent assay (ELISA) for sex hormone-binding globulin (SHBG) has been developed. Polyclonal antibody raised to SHBG purified to homogeneity was employed. The ELISA, which may be performed in under 4 h, shows no cross-reactivity with other serum proteins, has a sensitivity of less than 1.2 fmol per sample, demonstrates excellent correlation with ligand-binding techniques (r = 0.996; p less than 0.0001), and has intra- and inter-assay coefficients of variation of between 5-9% and 7-11% respectively.

Effects of prednisolone on sex hormone binding globulin during primary endocrine treatment of advanced breast cancer

Serum sex hormone binding globulin (SHBG) was measured in 21 pre and 39 postmenopausal women with advanced breast cancer before treatment and 1, 3, 6, 9 and 12 months after ovarian irradiation or during continuous administration of tamoxifen at a dose of 10 mg twice daily, respectively; some patients received additional prednisolone at a dose of 5 mg twice a day. Ovarian irradiation was associated with a 25% reduction in serum SHBG levels 3 to 6 months after treatment whilst patients on tamoxifen experienced a rise of about 80% in serum SHBG levels after 1 to 3 months. In postmenopausal women prednisolone markedly dampened the effect of tamoxifen, reducing a 80% rise to about 20%. There was no relationship between SHBG levels and response to treatment.

Weight loss and sex steroid metabolism in massively obese man

To evaluate the effect of weight loss and diet therapy on plasma sex hormone behavior in male obesity, 9 men with a BMI of 43.4 +/- 6.3 participated in an 8-week semistarvation program [whose energy content ranged from 320 to 500 k calorie/day (proteins 44 to 60 g and carbohydrates 54 to 81 g per day)] followed by a two-week hypocaloric (1000 k calorie/day) refeeding. In basal conditions, obese patients presented higher estrogen and lower dehydroepiandrosterone sulphate, testosterone (total and free) and sex-hormone binding globulin concentrations with respect to a group of control normal-weight subjects. Cumulative weight loss was 23.9 +/- 3.6 kg after semistarvation and 24.4 +/- 4.8 kg after refeeding (p = NS). A significant increase in testosterone, free testosterone and dehydroepiandrosterone sulfate was observed throughout the study, irrespective of dietary intake. A transient increase occurred in estrone levels while 17B-estradiol did not change. Gonadotropins and sex-hormone binding globulin values remained unaltered. No relationship was found between sex hormones and dietary energy content or composition. Daily urine free cortisol, which was used as a parameter of adrenal function, fell approximately 50% during semistarvation but returned to baseline values after refeeding. These results show that in massively obese patients weight loss per se may partially reverse sex hormone abnormalities but not sex-hormone binding globulin concentrations. It remains to be determined whether the return to "normal weight" can normalize steroid metabolic derangements in the obese man.

Sex hormone binding globulin in saliva

Measurement of salivary steroid hormone concentrations has frequently been advocated as a convenient alternative to plasma measurements. This is partly due to the belief that salivary steroid concentrations are a reliable reflection of the plasma free hormone level, a belief reinforced by earlier inability to demonstrate the presence of significant quantities of steroid binding proteins. Recent reports confirm that such quantities of these proteins are present in saliva and that they retain their steroid binding activity. We have measured sex hormone binding globulin (SHBG) and albumin in saliva from 14 men, 21 non-pregnant women and 36 pregnant women. No differences in the concentration of salivary albumin was evident in any of the groups studied whereas a significant difference in the concentration of SHBG was evident between men and non-pregnant women, and non-pregnant and pregnant individuals. Although much lower, salivary SHBG and albumin concentrations broadly reflect those found in plasma. Furthermore, a highly significant correlation existed between salivary SHBG and albumin concentrations in all groups studied. It now seems generally accepted that the albumin present in saliva arises from contamination by either traces of blood or gingival fluids. The close relationship between the concentrations of albumin and SHBG in saliva suggests that they both gain entry by a similar route. Furthermore, their presence may significantly influence the concentration of certain steroids in saliva, and this may explain the occasional failure of salivary steroid concentrations to accurately reflect the plasma free hormone levels.

The binding of blood-borne estrogens in normal vegetarian and omnivorous women and the risk of breast cancer

Serial blood samples were taken at two-hour intervals over a 24-hour period from 25 premenopausal vegetarians (12 vegans and 13 ovolactovegetarians) and from 21 omnivorous controls. All members of the former group had been on a vegetarian diet for a minimum of three years. The mean proportion of estradiol unbound to blood proteins was similar in both vegetarians (1.26%) and meat eaters (1.16%). However, the amount bound to albumin was significantly raised in vegetarians (50.1% vs. 43.1%, p less than 0.009), whereas that bound to sex hormone-binding globulin (SHBG) was correspondingly lower (48.7% vs. 55.8%, p = 0.01). Mean levels of SHBG were similar in vegetarians (59.9 nmole/l) and omnivores (62.0 nmole/l), as was the total amount of free fatty acid (0.42 mmole/l for both). Within the vegetarian group, no differences were detected between vegans and ovolactovegetarians.

An enzyme-linked immunosorbent assay (ELISA) for human sex hormone-binding globulin

An enzyme-linked immunosorbent assay (ELISA) of the "sandwich-type" for sex hormone binding globulin (SHBG) has been developed. A rabbit anti-SHBG antibody (RAb) is immobilized to the microtitre plate. After incubation with standards and samples a second monospecific rabbit anti-SHBG antibody, labelled with alkaline phosphatase is added (RAb). Following further washing substrate is added, colour developed and the plate read at 405 nm wavelength on a standard ELISA plate reader. The assay is not influenced by the presence of steroids at the binding site, and shows good agreement to SHBG binding capacity assay and commercially available IRMA. Its sensitivity, specificity and precision allows its use in the routine laboratory. The SHBG ELISA has been used to measure SHBG concentrations in sera of normal men, women, pregnant women, and women receiving high-dose medroxyprogesterone acetate as a treatment of metastatic breast cancer.

Sex hormone binding globulin and risk factors for breast cancer in a population of normal women who had never used exogenous sex hormones

Sex hormone binding globulin (SHBG) concentrations were measured by immunoradiometric assay in serum samples from 1,221 healthy female volunteers aged 34-79 who had never used oral contraceptives or hormone replacement therapy, had no history of thyroid disease or cancer, and had not used any drugs known to influence SHBG in the 14 days preceding blood sampling. There were 616 premenopausal and 605 naturally postmenopausal women. In both premenopausal and postmenopausal women, SHBG decreased with increasing weight (Quetelt's Index) and was lower in single nulliparous women than in married nulliparous women or parous women. In premenopausal women, SHBG was higher in women with late menarche, was higher in smokers than in non-smokers, and was higher in blood samples taken during the first 12 days of the luteal phase than during the rest of the menstrual cycle. In postmenopausal women, SHBG increased with years since the menopause. The possible biological importance of these findings is discussed with particular reference to risk factors for breast cancer.

Sex hormones in obese premenopausal women and their relationships to body fat mass and distribution, B cell function and diet composition

We examined sex hormone blood concentrations in a group of 33 obese non-hirsute premenopausal women with normal menses and in 14 age-matched normal-weight controls, and evaluated their relationship with anthropometric parameters, dietary habits and insulin levels. Obese women showed lower than control sex hormone-binding globulin (24.9 +/- 14.6 vs 38.6 +/- 12.5 nmol/l; p less than 0.005) and 5 alpha-dihydrotestosterone (13.7 +/- 5.4 vs 18.2 +/- 4.8 ng/dl; p less than 0.005) values. Despite their consensual behavior, the correlation coefficient between 5 alpha-dihydrotestosterone and sex hormone-binding globulin was not significant in the obese while in controls it was 0.68 (p less than 0.01). This suggests that mechanisms operating to lower the plasma levels of these compounds may be regulated differently in obesity. Body Mass Index, per cent body fat and its distribution showed a highly significant negative correlation with sex-hormone binding-globulin and 5 alpha-dihydrotestosterone values. Insulin levels did not appear to be correlated with sex hormone values. On the contrary, in the obese women we found a highly significant correlation between dietary lipids and sex-hormone-binding-globulin levels (r = -0.54; p less than 0.005) and between dietary carbohydrates and estrone values (r = 0.47; p less than 0.005); all these relationships were independent of body weight. These results confirm that in premenopausal women obesity may be characterized by detectable changes in sex steroid metabolism and suggest a possible causal role not only of the excessive quantity of metabolically active adipose tissue but also of specific dietary factors.

The cDNA-deduced primary structure of human sex hormone-binding globulin and location of its steroid-binding domain

We have sequenced a cDNA for sex hormone-binding globulin (SHBG) isolated from a phage lambda gt11 human liver cDNA library. The library was screened with a radiolabeled rat androgen-binding protein (ABP) cDNA, and the abundance of SHBG cDNAs was 1 in 750,000 plaques examined. The largest human SHBG cDNA (1194 base-pairs) contained a reading frame for 381 amino acids. This comprised 8 amino acids of a signal peptide followed by 373 residues starting with the known NH2-terminal sequence of human SHBG, and ending with a termination codon. The predicted polypeptide Mr of SHBG is 40,509, and sites of attachment of one O-linked (residue 7) and two N-linked oligosaccharide (residues 351 and 367) chains were identified. Purified SHBG was photoaffinity-labeled with delta 6-[3H]testosterone and cleaved with trypsin. The labeled tryptic fragment was isolated by reverse-phase HPLC, and its NH2-terminal sequence was determined. The results suggest that a portion of the steroid-binding domain of SHBG is located between residue 296 and the 35 predominantly hydrophilic residues at the C-terminus of the protein.

Dimerization of SHBG by gelatin and dithiothreitol. Implications for the measurement of SHBG binding capacity in human serum

In individual serum samples, the sex hormone-binding globulin (SHBG) binding capacity for dihydrotestosterone (DHT) was systematically found to be decreased by 30-60% when either gelatin or dithiothreitol (DTT) was present in the assay buffer. The presence of gelatin in the buffer prevented DTT from further decreasing the SHBG binding capacity of serum samples, suggesting a similar mechanism of action on SHBG for both of these substances. This observation led us to compare the molecular forms of SHBG by high performance liquid chromatography on a TSK G 3000 SW column, in the presence or absence of DTT. When undiluted serum previously incubated with [3H]DHT was chromatographed, only monomeric SHBG could be detected, independently of the presence or absence of DTT in the elution buffer. When the serum was diluted, incubated and chromatographed with buffer devoid of DTT, a dimeric SHBG peak was progressively observed, as a function of the sample dilution. Furthermore, for a given serum dilution, the relative size of the dimeric SHBG peak was also dependent on the steroid concentration present in the sample. By contrast, when serum was diluted, incubated and chromatographed with DTT-supplemented buffer, only the SHBG dimer peak could be detected. These results suggest that in serum, in vitro at least, SHBG is present in its monomeric form. Serum dilution with buffer devoid of DTT or gelatin induces the progressive dimerization of the protein, resulting in a progressive decrease of its apparent binding capacity. This could explain the great discrepancies of SHBG levels as reported in the literature. Because serum dilution with buffer supplemented with DTT or gelatin induces the complete dimerization of SHBG, independently of the sample dilution, we suggest that these substances be routinely used for the measurement of SHBG binding capacity. The SHBG binding capacity obtained in these latter conditions reflects however half the binding capacity of undiluted serum.

A 7-week follow-up study of the behaviour of testosterone and cortisol during the competition period in rowers

Nine rowers (six men of the regional and three women of the national top class) participated in the study. During 7 consecutive weeks of the competition period serum testosterone (T), SHBG, cortisol (C) and urea were determined at the same time every morning under fasting conditions. From the concentrations of T and SHBG the free testosterone fraction (T/SHBG) was calculated, and from the concentrations of T and C the ratio of T/C was derived. The object of the investigation was to gather information on a potentially altered anabolic-catabolic hormone relationship dependent upon the intensity of the individual training periods. All rowers showed a continuous decrease in T, T/SHBG and T/C during the observation period. A week of regenerative training halted the decrease. In two of the oarsmen who discontinued their training after 2 and 3 weeks respectively, T, T/SHBG and T/C showed a normalization in the following weeks. In all subjects the concentrations of urea increased during the first 2 weeks and decreased during the subsequent weeks of intense training and competition. The findings suggest an increase in catabolic activity in periods of intensive physical strain, including competitions. Regenerative phases of training seem to reduce the anabolic-catabolic imbalance.

Binding of oestradiol to blood proteins and aetiology of breast cancer

A prospective study of 5,000 women has shown that, compared to controls, those who subsequently developed breast cancer had a higher proportion of their blood oestradiol in the non-protein-bound and albumin-bound fractions (the bio-available fraction) and a lower proportion in the sex-hormone-bound fraction. The increased proportion of bio-available oestradiol was partly due to a lower concentration of sex-hormone-binding globulin. Weight was excluded as a confounding factor.

Changes in serum sex hormone-binding globulin, free estradiol, and testosterone during gonadotropin treatment

Sex hormone-binding globulin (SHBG), estradiol (E2), percent free E2, percent of E2 bound to SHBG, and testosterone (T) were evaluated in 28 ovulatory women during human menopausal gonadotropin-stimulated cycles for in vitro fertilization. Patients were divided into two categories: low responders, in whom serum E2 concentration reached levels less than 1000 pg/ml (mean, 638 +/- 93), and high responders, with serum E2 levels greater than 1000 pg/ml (mean, 2219 +/- 330). A significant increase in SHBG can occur within a short time in high responders (from 62.8 to 103.9 nmol/l) but not in low responders. This increase is accompanied by a significant decrease in the percent free (bioavailable) E2, but the distribution of E2 between the fraction bound to SHBG or albumin did not vary. Despite the increase in the levels of SHBG, the concentration of bioavailable (free) E2 in hyperstimulated women is higher than in normal cycles. The significant increase in T in high responders, by virtue of its higher affinity for SHBG, probably contributes to the increased levels of bioavailable E2.

Physicochemical characteristics of human sex hormone binding globulin: evidence for two identical subunits

We have developed a rapid protocol for the purification of human sex hormone binding globulin (SHBG) which allows the protein to be purified from pregnancy serum within 48 h. This minimizes any possible degradation of the protein by serum proteases, and has enabled us to re-examine some important and controversial aspects of its structural composition. Our physicochemical data are consistent with the hypothesis that SHBG is a dimeric glycoprotein composed of 2 protomers that exhibit size heterogeneity (approximately 50 and approximately 52 K daltons). The dimeric SHBG molecule appears to contain only approximately 8% carbohydrate, and sequence information indicates that an N-linked oligosaccharide chain may be attached to residue 7 (asparagine) from the NH2-terminal amino acid (leucine). When compared with earlier reports, differences in the relative amounts of heavy (approximately 52 K) and light (approximately 50 K) protomers, and the microheterogeneity of NH2-terminal amino acids, have led us to conclude that they may be caused by proteolytic degradation in vivo as well as during the storage of blood samples prior to protein purification. However, the NH2-terminal amino acid sequence data indicate that the primary structures of the heavy protomers, which evidently interact to form the majority of SHBG dimer in serum, are similar and may even be identical. Evidence to support this is provided by the observation that a monoclonal antibody, which recognises a configurational epitope, interacts with two epitopes per native dimeric form of human SHBG.

Testosterone, SHBG and albumin in patients with ovarian carcinoma

Plasma testosterone, unbound testosterone, Sex Hormone Binding Globulin (SHBG) and albumin were studied in women with 'non-endocrine' ovarian carcinoma prior to and during chemotherapy. Fifty-one postmenopausal or oophorectomized women with cancer of the ovary were studied. The histologic types were IC, IIC, IIIC, V and FIGO stages I-IV. Tumor volumes were evaluated once a month using bimanual recto-vaginal palpation under anesthesia. Blood samples were drawn for testosterone radio-immunoassay, SHBG and albumin analysis on four occasions at monthly intervals. Plasma levels were compared with a control group of postmenopausal women, a control group of fertile women in the follicular phase of the menstrual cycle, and finally a control group of postmenopausal women with non-gynecologic disseminated malignant disease. Testosterone concentrations were found to be higher in women with carcinoma of the ovary than in postmenopausal controls and showed a relationship to tumor volume. Histologic type and FIGO stage were found to be less closely related to plasma testosterone concentration. No significant change was found in the unbound testosterone fraction. SHBG concentrations were elevated in the Large-tumor group. Albumin concentrations were decreased in the Large-tumor group, advanced tumor stage group and in the control group with non-gynecologic disseminated malignant disease.