SHBG Index Monitoring is the clinical practice of tracking and interpreting the calculated ratio or derived index involving Sex Hormone Binding Globulin (SHBG) and total hormone concentrations, such as the Free Androgen Index (FAI). SHBG is a critical glycoprotein that binds sex hormones, primarily testosterone and estradiol, thereby regulating their bioavailability. Monitoring this index provides a surrogate measure of the biologically active, unbound hormone fraction, which is vital for assessing androgen and estrogen status in both males and females.
Origin
This term originates from clinical chemistry and endocrinology as a practical and cost-effective method to estimate free hormone levels when direct measurement techniques are complex or unavailable. The index serves as a powerful indicator of metabolic health, as SHBG levels are highly sensitive to changes in insulin resistance, thyroid function, and liver health. Monitoring allows clinicians to track the impact of lifestyle and pharmaceutical interventions on hormone availability.
Mechanism
The mechanism of monitoring relies on the inverse relationship between SHBG levels and free hormone concentration; as SHBG increases, the free fraction decreases, and vice versa. The Free Androgen Index, for example, is typically calculated as the ratio of total testosterone to SHBG, multiplied by a constant. Interpreting this index allows the clinician to infer changes in insulin sensitivity, since hyperinsulinemia is a potent suppressor of SHBG synthesis in the liver, thus increasing the free fraction of sex hormones.
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