Valvular & structural heart disease
Mitral valve prolapse: incidence and prognosis related to serum levels of sex hormone-binding globulin
Authors' conclusion
Elevated serum SHBG levels are associated with increased risk and adverse prognosis of MVP, providing insights into sex-related differences, risk stratification, and potential therapeutic targets.
Study context
- Population
- Participants in the UK Biobankparticipants in the UK Biobank, 970 developed mitral valve prolapse (MVP)
- Participants
- 472,178 participants
- Exposure
- Associations of sex hormone binding globulin (SHBG) and sex hormones (including testosterone and oestradiol) with incidence and prognosis of MVP
- Outcome
- Incident MVP
- Follow-up
- Median 13.67 years
Methodological detailsMendelian randomization
- Mendelian randomization
Main finding
As reported in the abstract
- Patients without a baseline MVP diagnosis developed MVP
- 970
Observational data: associations, not effects.
Further findings
MVP risk by SHBG (multivariable)
| HR (95% CI) | ||
|---|---|---|
| SHBGMultivariable model adjusted for confounders | 1.440 (1.201–1.726) | |
| 0.512Hazard ratio (log scale) |
All-cause mortality in MVP patients
| HR (95% CI) | ||
|---|---|---|
| Elevated SHBG level | 2.223 (1.430–3.457) | |
| 0.20.5125Hazard ratio (log scale) |
Incident MVP by SHBG quintile
- Higher risk in second, third, and fourth quintiles vs lowest quintile
- 8.1, 39.1, and 49.3%
Consistency across sexes
- Association consistent across sexes
- P for interaction = 0.4434
Mendelian randomization
- Supported a causal relationship between genetically predicted SHBG levels and increased MVP risk in both females and males
Original publication
Mitral valve prolapse: incidence and prognosis related to serum levels of sex hormone-binding globulin. Eur Heart J Qual Care Clin Outcomes. Published 16 December 2025. doi:10.
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