Regarding the association between sex hormone levels and heart structure, recent studies have shown that higher free testosterone and lower SHBG levels are associated with greater LV mass and an increased LV mass-volume-ratio (concentric remodeling) (7), higher endothelial dysfunction assessed using brachial artery flow-mediated dilation (33), higher LV diastolic dysfunction (34), and greater coronary artery calcium score progression (35). Here, SHBG is linked to endothelial dysfunction.