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Published in: Arthritis Research & Therapy 1/2020

01-12-2020 | Osteoarthrosis | Research article

Sex hormone-binding globulin and arthritis: a Mendelian randomization study

Authors: Zihao Qu, Jiawei Huang, Fangkun Yang, Jianqiao Hong, Wei Wang, Shigui Yan

Published in: Arthritis Research & Therapy | Issue 1/2020

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Abstract

Background

Sex hormone-binding globulin (SHBG) has been reported to be a risk factor associated with the development of arthritis by previous observational studies more so of three common forms of arthritis: osteoarthritis (OA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS). This study aimed to determine whether the concentrations of circulating SHBG are causally associated with the risk of OA, RA, and AS.

Methods

The two-sample Mendelian randomization (MR) approach was used for this study. The inverse-variance-weighted (IVW) method was used for the main analysis. Single-nucleotide polymorphisms (SNPs) associated with SHBG were selected from a large genome-wide association study (GWAS) of 28,837 European individuals. The summary statistics for OA, RA, and AS were extracted from the UK Biobank Resource (n = 361,141) and a GWAS dataset (n = 455,221).

Results

Positive causal associations were found between circulating SHBG concentrations and OA (effect = 1.086; 95% CI, 1.009 to 1.168; P = 0.027) and RA (effect = 1.003; 95% CI, 1.000 to 1.007; P = 0.047) in overall analyses. However, there was no evidence of association between SHBG levels and AS. Based on the stratification of skeletal sites, SHBG levels were found to be significantly associated with hip OA (effect = 1.423; 95% CI, 1.219 to 1.660; P = 7.753 × 10−6). However, this was not the case with knee OA.

Conclusions

There were positive causal effects of circulating SHBG on the development of OA and RA. Moreover, there was a site-specific association between SHBG and hip OA. Evidently, measurement of SHBG in serum could be valuable in the clinical assessment of arthritis especially in early screening and prevention of OA and RA. However, the mechanisms by which SHBG plays causal roles in the development of arthritis require further investigations.
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Literature
1.
go back to reference Tubach F, Ravaud P, Martin-Mola E, Awada H, Bellamy N, Bombardier C, et al. Minimum clinically important improvement and patient acceptable symptom state in pain and function in rheumatoid arthritis, ankylosing spondylitis, chronic back pain, hand osteoarthritis, and hip and knee osteoarthritis: results from a prospective multinational study. Arthritis Care Research. 2012;64(11):1699–707.PubMedCrossRef Tubach F, Ravaud P, Martin-Mola E, Awada H, Bellamy N, Bombardier C, et al. Minimum clinically important improvement and patient acceptable symptom state in pain and function in rheumatoid arthritis, ankylosing spondylitis, chronic back pain, hand osteoarthritis, and hip and knee osteoarthritis: results from a prospective multinational study. Arthritis Care Research. 2012;64(11):1699–707.PubMedCrossRef
2.
go back to reference Nigrovic PA, Raychaudhuri S, Thompson SD. Genetics and the classification of arthritis in adults and children. Arthritis Rheumatol. 2018;70(1):7–17.PubMedCrossRef Nigrovic PA, Raychaudhuri S, Thompson SD. Genetics and the classification of arthritis in adults and children. Arthritis Rheumatol. 2018;70(1):7–17.PubMedCrossRef
3.
go back to reference Glyn-Jones S, Palmer A, Agricola R, Price A, Vincent T, Weinans H, et al. Osteoarthritis. Lancet. 2015;386(9991):376–87.PubMedCrossRef Glyn-Jones S, Palmer A, Agricola R, Price A, Vincent T, Weinans H, et al. Osteoarthritis. Lancet. 2015;386(9991):376–87.PubMedCrossRef
4.
go back to reference Martel-Pelletier J, Barr AJ, Cicuttini FM, Conaghan PG, Cooper C, Goldring MB, et al. Osteoarthritis. Nature Reviews Disease Primers. 2016;2(1):16072.PubMedCrossRef Martel-Pelletier J, Barr AJ, Cicuttini FM, Conaghan PG, Cooper C, Goldring MB, et al. Osteoarthritis. Nature Reviews Disease Primers. 2016;2(1):16072.PubMedCrossRef
5.
go back to reference Sinusas K. Osteoarthritis: diagnosis and treatment. Am Fam Physician. 2012;85(1):49–56.PubMed Sinusas K. Osteoarthritis: diagnosis and treatment. Am Fam Physician. 2012;85(1):49–56.PubMed
6.
go back to reference Sarzi-Puttini P, Cimmino MA, Scarpa R, Caporali R, Parazzini F, Zaninelli A, et al. Osteoarthritis: an overview of the disease and its treatment strategies. Semin Arthritis Rheum. 2005;35(1 Suppl 1). Sarzi-Puttini P, Cimmino MA, Scarpa R, Caporali R, Parazzini F, Zaninelli A, et al. Osteoarthritis: an overview of the disease and its treatment strategies. Semin Arthritis Rheum. 2005;35(1 Suppl 1).
7.
go back to reference Ledingham J, Snowden N, Ide Z. Diagnosis and early management of inflammatory arthritis. BMJ. 2017;358:j3248. Ledingham J, Snowden N, Ide Z. Diagnosis and early management of inflammatory arthritis. BMJ. 2017;358:j3248.
8.
go back to reference Symmons D, Turner G, Webb R, Asten P, Barrett E, Lunt M, et al. The prevalence of rheumatoid arthritis in the United Kingdom: new estimates for a new century. Rheumatology. 2002;41(7):793–800.PubMedCrossRef Symmons D, Turner G, Webb R, Asten P, Barrett E, Lunt M, et al. The prevalence of rheumatoid arthritis in the United Kingdom: new estimates for a new century. Rheumatology. 2002;41(7):793–800.PubMedCrossRef
9.
go back to reference Deane KD, Demoruelle MK, Kelmenson LB, Kuhn KA, Norris JM, Holers VM. Genetic and environmental risk factors for rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2017;31(1):3–18.PubMedPubMedCentralCrossRef Deane KD, Demoruelle MK, Kelmenson LB, Kuhn KA, Norris JM, Holers VM. Genetic and environmental risk factors for rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2017;31(1):3–18.PubMedPubMedCentralCrossRef
11.
go back to reference Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G. A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthr Cartil. 2005;13(9):769–81.PubMedCrossRef Srikanth VK, Fryer JL, Zhai G, Winzenberg TM, Hosmer D, Jones G. A meta-analysis of sex differences prevalence, incidence and severity of osteoarthritis. Osteoarthr Cartil. 2005;13(9):769–81.PubMedCrossRef
12.
go back to reference Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. The Framingham osteoarthritis study. Arthritis Rheumatism. 1987;30(8):914–8.PubMedCrossRef Felson DT, Naimark A, Anderson J, Kazis L, Castelli W, Meenan RF. The prevalence of knee osteoarthritis in the elderly. The Framingham osteoarthritis study. Arthritis Rheumatism. 1987;30(8):914–8.PubMedCrossRef
13.
go back to reference Smith MV, Nepple JJ, Wright RW, Matava MJ, Brophy RH. Knee osteoarthritis is associated with previous meniscus and anterior cruciate ligament surgery among elite college American football athletes. Sports Health. 2017;9(3):247–51.PubMedCrossRef Smith MV, Nepple JJ, Wright RW, Matava MJ, Brophy RH. Knee osteoarthritis is associated with previous meniscus and anterior cruciate ligament surgery among elite college American football athletes. Sports Health. 2017;9(3):247–51.PubMedCrossRef
14.
go back to reference Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF. Obesity and knee osteoarthritis: the Framingham study. Ann Intern Med. 1988;109(1):18–24.PubMedCrossRef Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF. Obesity and knee osteoarthritis: the Framingham study. Ann Intern Med. 1988;109(1):18–24.PubMedCrossRef
15.
go back to reference Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis Res Therapy. 2002;4(S3):S265.CrossRef Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis Res Therapy. 2002;4(S3):S265.CrossRef
16.
go back to reference Heliövaara M, Aho K, Aromaa A, Knekt P, Reunanen A. Smoking and risk of rheumatoid arthritis. J Rheumatol. 1993;20(11):1830–5.PubMed Heliövaara M, Aho K, Aromaa A, Knekt P, Reunanen A. Smoking and risk of rheumatoid arthritis. J Rheumatol. 1993;20(11):1830–5.PubMed
17.
go back to reference Källberg H, Jacobsen S, Bengtsson C, Pedersen M, Padyukov L, Garred P, et al. Alcohol consumption is associated with decreased risk of rheumatoid arthritis: results from two Scandinavian case–control studies. Ann Rheum Dis. 2009;68(2):222–7.PubMedCrossRef Källberg H, Jacobsen S, Bengtsson C, Pedersen M, Padyukov L, Garred P, et al. Alcohol consumption is associated with decreased risk of rheumatoid arthritis: results from two Scandinavian case–control studies. Ann Rheum Dis. 2009;68(2):222–7.PubMedCrossRef
18.
go back to reference Lee YH, Bae S-C, Song GG. Coffee or tea consumption and the risk of rheumatoid arthritis: a meta-analysis. Clin Rheumatol. 2014;33(11):1575–83.PubMedCrossRef Lee YH, Bae S-C, Song GG. Coffee or tea consumption and the risk of rheumatoid arthritis: a meta-analysis. Clin Rheumatol. 2014;33(11):1575–83.PubMedCrossRef
19.
go back to reference Thomas GP, Brown MA. Genetics and genomics of ankylosing spondylitis. Immunol Rev. 2010;233(1):162–80.PubMedCrossRef Thomas GP, Brown MA. Genetics and genomics of ankylosing spondylitis. Immunol Rev. 2010;233(1):162–80.PubMedCrossRef
20.
go back to reference Ward MM, Weisman MH, Davis JC Jr, Reveille JD. Risk factors for functional limitations in patients with long-standing ankylosing spondylitis. Arthritis Care Res. 2005;53(5):710–7.CrossRef Ward MM, Weisman MH, Davis JC Jr, Reveille JD. Risk factors for functional limitations in patients with long-standing ankylosing spondylitis. Arthritis Care Res. 2005;53(5):710–7.CrossRef
21.
go back to reference Simó R, Sáez-López C, Barbosa-Desongles A, Hernández C, Selva DM. Novel insights in SHBG regulation and clinical implications. Trends Endocrinol Metabolism. 2015;26(7):376–83.CrossRef Simó R, Sáez-López C, Barbosa-Desongles A, Hernández C, Selva DM. Novel insights in SHBG regulation and clinical implications. Trends Endocrinol Metabolism. 2015;26(7):376–83.CrossRef
22.
go back to reference Spector T, Perry L, Jubb R. Endogenous sex steroid levels in women with generalised osteoarthritis. Clin Rheumatol. 1991;10(3):316–9.PubMedCrossRef Spector T, Perry L, Jubb R. Endogenous sex steroid levels in women with generalised osteoarthritis. Clin Rheumatol. 1991;10(3):316–9.PubMedCrossRef
23.
go back to reference Petra PH. The plasma sex steroid binding protein (SBP or SHBG). A critical review of recent developments on the structure, molecular biology and function. J Steroid Biochem Mol Biol. 1991;40(4–6):735–53.PubMedCrossRef Petra PH. The plasma sex steroid binding protein (SBP or SHBG). A critical review of recent developments on the structure, molecular biology and function. J Steroid Biochem Mol Biol. 1991;40(4–6):735–53.PubMedCrossRef
24.
go back to reference de Ronde W, van der Schouw YT, Muller M, Grobbee DE, Gooren LJG, Pols HAP, et al. Associations of sex-hormone-binding globulin (SHBG) with non-SHBG-bound levels of testosterone and estradiol in independently living men. J Clin Endocrinol Metab. 2005;90(1):157–62.PubMedCrossRef de Ronde W, van der Schouw YT, Muller M, Grobbee DE, Gooren LJG, Pols HAP, et al. Associations of sex-hormone-binding globulin (SHBG) with non-SHBG-bound levels of testosterone and estradiol in independently living men. J Clin Endocrinol Metab. 2005;90(1):157–62.PubMedCrossRef
25.
26.
go back to reference Sekula P, Fabiola Del Greco M, Pattaro C, Köttgen A. Mendelian randomization as an approach to assess causality using observational data. J Am Soc Nephrol. 2016;27(11):3253–65.PubMedPubMedCentralCrossRef Sekula P, Fabiola Del Greco M, Pattaro C, Köttgen A. Mendelian randomization as an approach to assess causality using observational data. J Am Soc Nephrol. 2016;27(11):3253–65.PubMedPubMedCentralCrossRef
27.
go back to reference Panoutsopoulou K, Metrustry S, Doherty SA, Laslett LL, Maciewicz RA, Hart DJ, et al. The effect of FTO variation on increased osteoarthritis risk is mediated through body mass index: a mendelian randomisation study. Ann Rheum Dis. 2014;73(12):2082–6.PubMedCrossRef Panoutsopoulou K, Metrustry S, Doherty SA, Laslett LL, Maciewicz RA, Hart DJ, et al. The effect of FTO variation on increased osteoarthritis risk is mediated through body mass index: a mendelian randomisation study. Ann Rheum Dis. 2014;73(12):2082–6.PubMedCrossRef
28.
go back to reference Song GG, Lee YH. Causal association between bone mineral density and osteoarthritis: a Mendelian randomization study. J Rheumatic Diseases. 2019;26(2):104–10.CrossRef Song GG, Lee YH. Causal association between bone mineral density and osteoarthritis: a Mendelian randomization study. J Rheumatic Diseases. 2019;26(2):104–10.CrossRef
29.
go back to reference Lee YH. Causal association between smoking behavior and the decreased risk of osteoarthritis: a Mendelian randomization. Z Rheumatol. 2019;78(5):461–6.PubMedCrossRef Lee YH. Causal association between smoking behavior and the decreased risk of osteoarthritis: a Mendelian randomization. Z Rheumatol. 2019;78(5):461–6.PubMedCrossRef
30.
go back to reference Lee YH. Investigating the possible causal association of coffee consumption with osteoarthritis risk using a Mendelian randomization analysis. Clin Rheumatol. 2018;37(11):3133–9.PubMedCrossRef Lee YH. Investigating the possible causal association of coffee consumption with osteoarthritis risk using a Mendelian randomization analysis. Clin Rheumatol. 2018;37(11):3133–9.PubMedCrossRef
31.
go back to reference Li B, Xiao Y, Xing D, Ma X-L, Liu J. Circulating interleukin-6 and rheumatoid arthritis: a Mendelian randomization meta-analysis. Medicine (Baltimore). 2016;95(23):e3855. Li B, Xiao Y, Xing D, Ma X-L, Liu J. Circulating interleukin-6 and rheumatoid arthritis: a Mendelian randomization meta-analysis. Medicine (Baltimore). 2016;95(23):e3855.
32.
go back to reference Cheng W-W, Zhu Q, Zhang H-Y. Mineral nutrition and the risk of chronic diseases: a Mendelian randomization study. Nutrients. 2019;11(2):378.PubMedCentralCrossRef Cheng W-W, Zhu Q, Zhang H-Y. Mineral nutrition and the risk of chronic diseases: a Mendelian randomization study. Nutrients. 2019;11(2):378.PubMedCentralCrossRef
33.
go back to reference Bae S-C, Lee YH. Vitamin D level and risk of systemic lupus erythematosus and rheumatoid arthritis: a Mendelian randomization. Clin Rheumatol. 2018;37(9):2415–21.PubMedCrossRef Bae S-C, Lee YH. Vitamin D level and risk of systemic lupus erythematosus and rheumatoid arthritis: a Mendelian randomization. Clin Rheumatol. 2018;37(9):2415–21.PubMedCrossRef
34.
go back to reference Coviello AD, Haring R, Wellons M, Vaidya D, Lehtimäki T, Keildson S, et al. A genome-wide association meta-analysis of circulating sex hormone-binding globulin reveals multiple Loci implicated in sex steroid hormone regulation. PLoS genetics. 2012;8(7):e1002805. Coviello AD, Haring R, Wellons M, Vaidya D, Lehtimäki T, Keildson S, et al. A genome-wide association meta-analysis of circulating sex hormone-binding globulin reveals multiple Loci implicated in sex steroid hormone regulation. PLoS genetics. 2012;8(7):e1002805.
35.
go back to reference Tachmazidou I, Hatzikotoulas K, Southam L, Esparza-Gordillo J, Haberland V, Zheng J, et al. Identification of new therapeutic targets for osteoarthritis through genome-wide analyses of UK Biobank data. Nat Genet. 2019;51(2):230–6.PubMedPubMedCentralCrossRef Tachmazidou I, Hatzikotoulas K, Southam L, Esparza-Gordillo J, Haberland V, Zheng J, et al. Identification of new therapeutic targets for osteoarthritis through genome-wide analyses of UK Biobank data. Nat Genet. 2019;51(2):230–6.PubMedPubMedCentralCrossRef
36.
go back to reference Agricola R, Heijboer M, Roze R, Reijman M, Bierma-Zeinstra S, Verhaar J, et al. Pincer deformity does not lead to osteoarthritis of the hip whereas acetabular dysplasia does: acetabular coverage and development of osteoarthritis in a nationwide prospective cohort study (CHECK). Osteoarthr Cartil. 2013;21(10):1514–21.PubMedCrossRef Agricola R, Heijboer M, Roze R, Reijman M, Bierma-Zeinstra S, Verhaar J, et al. Pincer deformity does not lead to osteoarthritis of the hip whereas acetabular dysplasia does: acetabular coverage and development of osteoarthritis in a nationwide prospective cohort study (CHECK). Osteoarthr Cartil. 2013;21(10):1514–21.PubMedCrossRef
37.
go back to reference Astephen JL, Deluzio KJ, Caldwell GE, Dunbar MJ. Biomechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity. J Orthop Res. 2008;26(3):332–41.PubMedCrossRef Astephen JL, Deluzio KJ, Caldwell GE, Dunbar MJ. Biomechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity. J Orthop Res. 2008;26(3):332–41.PubMedCrossRef
39.
go back to reference Hussain SM, Cicuttini FM, Bell RJ, Robinson PJ, Davis SR, Giles GG, et al. Incidence of total knee and hip replacement for osteoarthritis in relation to circulating sex steroid hormone concentrations in women. Arthritis Rheumatol. 2014;66(8):2144–51.PubMedCrossRef Hussain SM, Cicuttini FM, Bell RJ, Robinson PJ, Davis SR, Giles GG, et al. Incidence of total knee and hip replacement for osteoarthritis in relation to circulating sex steroid hormone concentrations in women. Arthritis Rheumatol. 2014;66(8):2144–51.PubMedCrossRef
40.
go back to reference Antony B, Venn A, Cicuttini F, March L, Blizzard L, Dwyer T, et al. Association of body composition and hormonal and inflammatory factors with tibial cartilage volume and sex difference in cartilage volume in young adults. Arthritis Care Res. 2016;68(4):517–25.CrossRef Antony B, Venn A, Cicuttini F, March L, Blizzard L, Dwyer T, et al. Association of body composition and hormonal and inflammatory factors with tibial cartilage volume and sex difference in cartilage volume in young adults. Arthritis Care Res. 2016;68(4):517–25.CrossRef
41.
go back to reference Hanna FS, Bell RJ, Cicuttini FM, Davison SL, Wluka AE, Davis SR. The relationship between endogenous testosterone, preandrogens, and sex hormone binding globulin and knee joint structure in women at midlife. Semin Arthritis Rheum. 2007;37(1):56–62. Hanna FS, Bell RJ, Cicuttini FM, Davison SL, Wluka AE, Davis SR. The relationship between endogenous testosterone, preandrogens, and sex hormone binding globulin and knee joint structure in women at midlife. Semin Arthritis Rheum. 2007;37(1):56–62.
42.
go back to reference Mirone L, Altomonte L, D'agostino P, Zoli A, Barini A, Magaro M. A study of serum androgen and cortisol levels in female patients with rheumatoid arthritis. Correlation with disease activity. Clin Rheumatol. 1996;15(1):15–9.PubMedCrossRef Mirone L, Altomonte L, D'agostino P, Zoli A, Barini A, Magaro M. A study of serum androgen and cortisol levels in female patients with rheumatoid arthritis. Correlation with disease activity. Clin Rheumatol. 1996;15(1):15–9.PubMedCrossRef
43.
go back to reference Tengstrand B, Carlström K, Hafström I. Bioavailable testosterone in men with rheumatoid arthritis—high frequency of hypogonadism. Rheumatology. 2002;41(3):285–9.PubMedCrossRef Tengstrand B, Carlström K, Hafström I. Bioavailable testosterone in men with rheumatoid arthritis—high frequency of hypogonadism. Rheumatology. 2002;41(3):285–9.PubMedCrossRef
44.
go back to reference Navarro M, Nolla J, Machuca M, González A, Mateo L, Bonnin R, et al. Salivary testosterone in postmenopausal women with rheumatoid arthritis. J Rheumatol. 1998;25(6):1059–62.PubMed Navarro M, Nolla J, Machuca M, González A, Mateo L, Bonnin R, et al. Salivary testosterone in postmenopausal women with rheumatoid arthritis. J Rheumatol. 1998;25(6):1059–62.PubMed
45.
go back to reference Mitra D, Elvins D, Collins A. Testosterone and testosterone free index in mild ankylosing spondylitis: relationship with bone mineral density and vertebral fractures. J Rheumatol. 1999;26(11):2414–7.PubMed Mitra D, Elvins D, Collins A. Testosterone and testosterone free index in mild ankylosing spondylitis: relationship with bone mineral density and vertebral fractures. J Rheumatol. 1999;26(11):2414–7.PubMed
46.
go back to reference Giltay E, Popp-Snijders C, Dekker-Saeys B, Gooren L, Dijkmans B. Serum testosterone levels are not elevated in patients with ankylosing spondylitis. J Rheumatol. 1998;25(12):2389–94.PubMed Giltay E, Popp-Snijders C, Dekker-Saeys B, Gooren L, Dijkmans B. Serum testosterone levels are not elevated in patients with ankylosing spondylitis. J Rheumatol. 1998;25(12):2389–94.PubMed
47.
go back to reference O'Connor MI. Sex differences in osteoarthritis of the hip and knee. JAAOS. 2007;15:S22–S5.PubMed O'Connor MI. Sex differences in osteoarthritis of the hip and knee. JAAOS. 2007;15:S22–S5.PubMed
48.
Metadata
Title
Sex hormone-binding globulin and arthritis: a Mendelian randomization study
Authors
Zihao Qu
Jiawei Huang
Fangkun Yang
Jianqiao Hong
Wei Wang
Shigui Yan
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 1/2020
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/s13075-020-02202-2

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