In principle, higher levels of vitamin D may strengthen the protective association of higher SHBG, either through independent pathophysiological mechanisms25–27 or as a factor that could increase androgen synthesis in men.28 Vitamin D and SHBG combinations may also simply represent incremental increases in degrees of chronic inflammation, with the lowest vitamin D/lowest SHBG representing the highest degree of chronic inflammation, and the highest vitamin D/highest SHBG representing the lowest degree of chronic inflammation. The gene discussed is SHBG; the disease is inflammation.