{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T03:41:39Z","timestamp":1790480499570,"version":"4.1.0"},"reference-count":48,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T00:00:00Z","timestamp":1589760000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T00:00:00Z","timestamp":1589760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81772360"],"award-info":[{"award-number":["81772360"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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 (<jats:italic>n<\/jats:italic>\u2009=\u2009361,141) and a GWAS dataset (<jats:italic>n<\/jats:italic>\u2009=\u2009455,221).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Positive causal associations were found between circulating SHBG concentrations and OA (effect\u2009=\u20091.086; 95% CI, 1.009 to 1.168;<jats:italic>P<\/jats:italic>\u2009=\u20090.027) and RA (effect\u2009=\u20091.003; 95% CI, 1.000 to 1.007;<jats:italic>P<\/jats:italic>\u2009=\u20090.047) 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\u2009=\u20091.423; 95% CI, 1.219 to 1.660;<jats:italic>P<\/jats:italic>\u2009=\u20097.753\u2009\u00d7\u200910<jats:sup>\u22126<\/jats:sup>). However, this was not the case with knee OA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13075-020-02202-2","type":"journal-article","created":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T17:04:17Z","timestamp":1589821457000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Sex hormone-binding globulin and arthritis: a Mendelian randomization study"],"prefix":"10.1186","volume":"22","author":[{"given":"Zihao","family":"Qu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangkun","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianqiao","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9096-2868","authenticated-orcid":false,"given":"Shigui","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,5,18]]},"reference":[{"issue":"11","key":"2202_CR1","doi-asserted-by":"publisher","first-page":"1699","DOI":"10.1002\/acr.21747","volume":"64","author":"F Tubach","year":"2012","unstructured":"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\u2013707.","journal-title":"Arthritis Care Research."},{"issue":"1","key":"2202_CR2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1002\/art.40350","volume":"70","author":"PA Nigrovic","year":"2018","unstructured":"Nigrovic PA, Raychaudhuri S, Thompson SD. Genetics and the classification of arthritis in adults and children. Arthritis Rheumatol. 2018;70(1):7\u201317.","journal-title":"Arthritis Rheumatol."},{"issue":"9991","key":"2202_CR3","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/S0140-6736(14)60802-3","volume":"386","author":"S Glyn-Jones","year":"2015","unstructured":"Glyn-Jones S, Palmer A, Agricola R, Price A, Vincent T, Weinans H, et al. Osteoarthritis. Lancet. 2015;386(9991):376\u201387.","journal-title":"Lancet"},{"issue":"1","key":"2202_CR4","doi-asserted-by":"publisher","first-page":"16072","DOI":"10.1038\/nrdp.2016.72","volume":"2","author":"J Martel-Pelletier","year":"2016","unstructured":"Martel-Pelletier J, Barr AJ, Cicuttini FM, Conaghan PG, Cooper C, Goldring MB, et al. Osteoarthritis. Nature Reviews Disease Primers. 2016;2(1):16072.","journal-title":"Nature Reviews Disease Primers"},{"issue":"1","key":"2202_CR5","first-page":"49","volume":"85","author":"K Sinusas","year":"2012","unstructured":"Sinusas K. Osteoarthritis: diagnosis and treatment. Am Fam Physician. 2012;85(1):49\u201356.","journal-title":"Am Fam Physician"},{"key":"2202_CR6","doi-asserted-by":"crossref","unstructured":"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).","DOI":"10.1016\/j.semarthrit.2005.01.013"},{"key":"2202_CR7","doi-asserted-by":"crossref","unstructured":"Ledingham J, Snowden N, Ide Z. Diagnosis and early management of inflammatory arthritis. BMJ. 2017;358:j3248.","DOI":"10.1136\/bmj.j3248"},{"issue":"7","key":"2202_CR8","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1093\/rheumatology\/41.7.793","volume":"41","author":"D Symmons","year":"2002","unstructured":"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\u2013800.","journal-title":"Rheumatology."},{"issue":"1","key":"2202_CR9","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.berh.2017.08.003","volume":"31","author":"KD Deane","year":"2017","unstructured":"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\u201318.","journal-title":"Best Pract Res Clin Rheumatol"},{"issue":"9570","key":"2202_CR10","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1016\/S0140-6736(07)60635-7","volume":"369","author":"J Braun","year":"2007","unstructured":"Braun J, Sieper J. Ankylosing spondylitis. Lancet. 2007;369(9570):1379\u201390.","journal-title":"Lancet"},{"issue":"9","key":"2202_CR11","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1016\/j.joca.2005.04.014","volume":"13","author":"VK Srikanth","year":"2005","unstructured":"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\u201381.","journal-title":"Osteoarthr Cartil"},{"issue":"8","key":"2202_CR12","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1002\/art.1780300811","volume":"30","author":"DT Felson","year":"1987","unstructured":"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\u20138.","journal-title":"Arthritis Rheumatism"},{"issue":"3","key":"2202_CR13","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1177\/1941738116683146","volume":"9","author":"MV Smith","year":"2017","unstructured":"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\u201351.","journal-title":"Sports Health"},{"issue":"1","key":"2202_CR14","doi-asserted-by":"publisher","first-page":"18","DOI":"10.7326\/0003-4819-109-1-18","volume":"109","author":"DT Felson","year":"1988","unstructured":"Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF. Obesity and knee osteoarthritis: the Framingham study. Ann Intern Med. 1988;109(1):18\u201324.","journal-title":"Ann Intern Med"},{"issue":"S3","key":"2202_CR15","doi-asserted-by":"publisher","first-page":"S265","DOI":"10.1186\/ar578","volume":"4","author":"AJ Silman","year":"2002","unstructured":"Silman AJ, Pearson JE. Epidemiology and genetics of rheumatoid arthritis. Arthritis Res Therapy. 2002;4(S3):S265.","journal-title":"Arthritis Res Therapy"},{"issue":"11","key":"2202_CR16","first-page":"1830","volume":"20","author":"M Heli\u00f6vaara","year":"1993","unstructured":"Heli\u00f6vaara M, Aho K, Aromaa A, Knekt P, Reunanen A. Smoking and risk of rheumatoid arthritis. J Rheumatol. 1993;20(11):1830\u20135.","journal-title":"J Rheumatol"},{"issue":"2","key":"2202_CR17","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1136\/ard.2007.086314","volume":"68","author":"H K\u00e4llberg","year":"2009","unstructured":"K\u00e4llberg 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\u2013control studies. Ann Rheum Dis. 2009;68(2):222\u20137.","journal-title":"Ann Rheum Dis"},{"issue":"11","key":"2202_CR18","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1007\/s10067-014-2631-1","volume":"33","author":"YH Lee","year":"2014","unstructured":"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\u201383.","journal-title":"Clin Rheumatol"},{"issue":"1","key":"2202_CR19","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1111\/j.0105-2896.2009.00852.x","volume":"233","author":"GP Thomas","year":"2010","unstructured":"Thomas GP, Brown MA. Genetics and genomics of ankylosing spondylitis. Immunol Rev. 2010;233(1):162\u201380.","journal-title":"Immunol Rev"},{"issue":"5","key":"2202_CR20","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1002\/art.21444","volume":"53","author":"MM Ward","year":"2005","unstructured":"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\u20137.","journal-title":"Arthritis Care Res"},{"issue":"7","key":"2202_CR21","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/j.tem.2015.05.001","volume":"26","author":"R Sim\u00f3","year":"2015","unstructured":"Sim\u00f3 R, S\u00e1ez-L\u00f3pez C, Barbosa-Desongles A, Hern\u00e1ndez C, Selva DM. Novel insights in SHBG regulation and clinical implications. Trends Endocrinol Metabolism. 2015;26(7):376\u201383.","journal-title":"Trends Endocrinol Metabolism"},{"issue":"3","key":"2202_CR22","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1007\/BF02208698","volume":"10","author":"T Spector","year":"1991","unstructured":"Spector T, Perry L, Jubb R. Endogenous sex steroid levels in women with generalised osteoarthritis. Clin Rheumatol. 1991;10(3):316\u20139.","journal-title":"Clin Rheumatol"},{"issue":"4\u20136","key":"2202_CR23","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1016\/0960-0760(91)90299-K","volume":"40","author":"PH Petra","year":"1991","unstructured":"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\u20136):735\u201353.","journal-title":"J Steroid Biochem Mol Biol"},{"issue":"1","key":"2202_CR24","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1210\/jc.2004-0422","volume":"90","author":"W de Ronde","year":"2005","unstructured":"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\u201362.","journal-title":"J Clin Endocrinol Metab"},{"issue":"19","key":"2202_CR25","doi-asserted-by":"publisher","first-page":"1925","DOI":"10.1001\/jama.2017.17219","volume":"318","author":"CA Emdin","year":"2017","unstructured":"Emdin CA, Khera AV, Kathiresan S. Mendelian randomization. JAMA. 2017;318(19):1925\u20136.","journal-title":"JAMA."},{"issue":"11","key":"2202_CR26","doi-asserted-by":"publisher","first-page":"3253","DOI":"10.1681\/ASN.2016010098","volume":"27","author":"P Sekula","year":"2016","unstructured":"Sekula P, Fabiola Del Greco M, Pattaro C, K\u00f6ttgen A. Mendelian randomization as an approach to assess causality using observational data. J Am Soc Nephrol. 2016;27(11):3253\u201365.","journal-title":"J Am Soc Nephrol"},{"issue":"12","key":"2202_CR27","doi-asserted-by":"publisher","first-page":"2082","DOI":"10.1136\/annrheumdis-2013-203772","volume":"73","author":"K Panoutsopoulou","year":"2014","unstructured":"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\u20136.","journal-title":"Ann Rheum Dis"},{"issue":"2","key":"2202_CR28","doi-asserted-by":"publisher","first-page":"104","DOI":"10.4078\/jrd.2019.26.2.104","volume":"26","author":"GG Song","year":"2019","unstructured":"Song GG, Lee YH. Causal association between bone mineral density and osteoarthritis: a Mendelian randomization study. J Rheumatic Diseases. 2019;26(2):104\u201310.","journal-title":"J Rheumatic Diseases"},{"issue":"5","key":"2202_CR29","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s00393-018-0505-7","volume":"78","author":"YH Lee","year":"2019","unstructured":"Lee YH. Causal association between smoking behavior and the decreased risk of osteoarthritis: a Mendelian randomization. Z Rheumatol. 2019;78(5):461\u20136.","journal-title":"Z Rheumatol"},{"issue":"11","key":"2202_CR30","doi-asserted-by":"publisher","first-page":"3133","DOI":"10.1007\/s10067-018-4252-6","volume":"37","author":"YH Lee","year":"2018","unstructured":"Lee YH. Investigating the possible causal association of coffee consumption with osteoarthritis risk using a Mendelian randomization analysis. Clin Rheumatol. 2018;37(11):3133\u20139.","journal-title":"Clin Rheumatol"},{"key":"2202_CR31","doi-asserted-by":"crossref","unstructured":"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.","DOI":"10.1097\/MD.0000000000003855"},{"issue":"2","key":"2202_CR32","doi-asserted-by":"publisher","first-page":"378","DOI":"10.3390\/nu11020378","volume":"11","author":"W-W Cheng","year":"2019","unstructured":"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.","journal-title":"Nutrients."},{"issue":"9","key":"2202_CR33","doi-asserted-by":"publisher","first-page":"2415","DOI":"10.1007\/s10067-018-4152-9","volume":"37","author":"S-C Bae","year":"2018","unstructured":"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\u201321.","journal-title":"Clin Rheumatol"},{"key":"2202_CR34","doi-asserted-by":"crossref","unstructured":"Coviello AD, Haring R, Wellons M, Vaidya D, Lehtim\u00e4ki 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.","DOI":"10.1371\/journal.pgen.1002805"},{"issue":"2","key":"2202_CR35","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1038\/s41588-018-0327-1","volume":"51","author":"I Tachmazidou","year":"2019","unstructured":"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\u20136.","journal-title":"Nat Genet"},{"issue":"10","key":"2202_CR36","doi-asserted-by":"publisher","first-page":"1514","DOI":"10.1016\/j.joca.2013.07.004","volume":"21","author":"R Agricola","year":"2013","unstructured":"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\u201321.","journal-title":"Osteoarthr Cartil"},{"issue":"3","key":"2202_CR37","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1002\/jor.20496","volume":"26","author":"JL Astephen","year":"2008","unstructured":"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\u201341.","journal-title":"J Orthop Res"},{"issue":"3","key":"2202_CR38","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1534\/genetics.110.122549","volume":"186","author":"FW Stearns","year":"2010","unstructured":"Stearns FW. One hundred years of pleiotropy: a retrospective. Genetics. 2010;186(3):767\u201373.","journal-title":"Genetics."},{"issue":"8","key":"2202_CR39","doi-asserted-by":"publisher","first-page":"2144","DOI":"10.1002\/art.38651","volume":"66","author":"SM Hussain","year":"2014","unstructured":"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\u201351.","journal-title":"Arthritis Rheumatol"},{"issue":"4","key":"2202_CR40","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1002\/acr.22715","volume":"68","author":"B Antony","year":"2016","unstructured":"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\u201325.","journal-title":"Arthritis Care Res"},{"key":"2202_CR41","doi-asserted-by":"crossref","unstructured":"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\u201362.","DOI":"10.1016\/j.semarthrit.2006.12.008"},{"issue":"1","key":"2202_CR42","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/BF02231678","volume":"15","author":"L Mirone","year":"1996","unstructured":"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\u20139.","journal-title":"Clin Rheumatol"},{"issue":"3","key":"2202_CR43","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1093\/rheumatology\/41.3.285","volume":"41","author":"B Tengstrand","year":"2002","unstructured":"Tengstrand B, Carlstr\u00f6m K, Hafstr\u00f6m I. Bioavailable testosterone in men with rheumatoid arthritis\u2014high frequency of hypogonadism. Rheumatology. 2002;41(3):285\u20139.","journal-title":"Rheumatology."},{"issue":"6","key":"2202_CR44","first-page":"1059","volume":"25","author":"M Navarro","year":"1998","unstructured":"Navarro M, Nolla J, Machuca M, Gonz\u00e1lez A, Mateo L, Bonnin R, et al. Salivary testosterone in postmenopausal women with rheumatoid arthritis. J Rheumatol. 1998;25(6):1059\u201362.","journal-title":"J Rheumatol"},{"issue":"11","key":"2202_CR45","first-page":"2414","volume":"26","author":"D Mitra","year":"1999","unstructured":"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\u20137.","journal-title":"J Rheumatol"},{"issue":"12","key":"2202_CR46","first-page":"2389","volume":"25","author":"E Giltay","year":"1998","unstructured":"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\u201394.","journal-title":"J Rheumatol"},{"key":"2202_CR47","doi-asserted-by":"crossref","first-page":"S22","DOI":"10.5435\/00124635-200700001-00007","volume":"15","author":"MI O'Connor","year":"2007","unstructured":"O'Connor MI. Sex differences in osteoarthritis of the hip and knee. JAAOS. 2007;15:S22\u2013S5.","journal-title":"JAAOS"},{"issue":"1","key":"2202_CR48","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1136\/ard.2006.056937","volume":"66","author":"K Forslind","year":"2007","unstructured":"Forslind K, Hafstr\u00f6m I, Ahlmen M, Svensson B. Sex: a major predictor of remission in early rheumatoid arthritis? Ann Rheum Dis. 2007;66(1):46\u201352.","journal-title":"Ann Rheum Dis"}],"container-title":["Arthritis Research &amp; Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13075-020-02202-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13075-020-02202-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13075-020-02202-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T02:51:50Z","timestamp":1666579910000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthritis-research.biomedcentral.com\/articles\/10.1186\/s13075-020-02202-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,18]]},"references-count":48,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["2202"],"URL":"https:\/\/doi.org\/10.1186\/s13075-020-02202-2","relation":{},"ISSN":["1478-6362"],"issn-type":[{"value":"1478-6362","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,18]]},"assertion":[{"value":"12 February 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 May 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All the studies used to compliment the current study were approved by relevant ethics committees. All participants involved provided a written informed consent.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors state that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"118"}}