• Günter Höfle, Gerda Tautermann, Christoph H Saely, and Heinz Drexel.
• Department of Internal Medicine, Vorarlberg Institute for Vascular Investigation and Treatment, Landeskrankenhaus Feldkirch, Feldkirch, Austria. guenter.hoefle@lkhf.at
• Wien. Klin. Wochenschr. 2004 Mar 31; 116 (5-6): 170-5.

BackgroundOsteoporosis and the subsequent increase in incidence of fractures are a common problem after cardiac transplantation.DesignWe performed a cross-sectional evaluation of male cardiac-transplant recipients in a late post-transplantation period (4.2 +/- 2.6 years after cardiac transplantation, n = 21). Bone-mineral density was measured by dual-energy X-ray absorptiometry and by quantitative heel ultrasound, and the endocrine characteristics of cardiac-transplant recipients with and without vertebral fractures were investigated.ResultsA significant negative correlation was observed between sex-hormone-binding globulin and femoral-neck bone-mineral density (rs = -0.699; p value = 0.001). Linear regression analysis controlling for age and body-mass index proved sex-hormone-binding globulin to be an independent negative predictor for femoral-neck bone-mineral density (r = -0.474; p value = 0.035). Patients with vertebral fractures had significantly lower femoral-neck bone-mineral density (pvalue = 0.035). However, sex-hormone-binding globulin, total and free testosterone, and estradiol did not exhibit significant associations with vertebral fractures in our patients.ConclusionThis investigation demonstrates for the first time an association between high sex-hormone-binding globulin levels and low femoral-neck bone-mineral density in a cohort of male cardiac-transplant recipients. Our data support the important role of sex-hormone-binding globulin in the pathogenesis of post-transplantation bone disease, although--possibly because of the small number of patients--we could not prove an interrelation of sex-hormone-binding globulin with vertebral fractures.

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