1. bookVolume 24 (2016): Issue 1 (March 2016)
Journal Details
License
Format
Journal
eISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
access type Open Access

Decreased serum levels of sex steroids associated with osteoporosis in a group of Romanian male patients

Published Online: 19 Mar 2016
Page range: 75 - 82
Received: 16 Sep 2015
Accepted: 16 Feb 2016
Journal Details
License
Format
Journal
eISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
Abstract

Introduction. With age, sex hormone deficiency leads to reduced bone mineral density (BMD) in men. The aim of our research is to analyze the role of serum sex steroids in assessing BMD in the men included in this study. Materials and methods. This cross-sectional study included 146 men aged 65-85 years old with osteopenia or osteoporosis (study group) and 121 men with normal BMD (control group). Serum levels of total testosterone (Tt) and free testosterone (Tf) were measured by immunoassay, and estradiol (E2) levels were measured by the immunoenzymatic method. Femoral neck and lumbar spine BMD was examined by dual-energy X-ray absorptiometry. Results. Tf and E2 deficiency was significantly associated with low BMD (p=0.007). No association was found between Tt deficiency and reduced BMD. Tf levels (p<0.001) and E2 levels (p=0.003) were significantly lower in patients with reduced BMD compared to those with normal BMD. Significant more cases with low levels of Tf (p=0.015) and E2 (p<0.001) were found in patients with osteoporosis compared to those with osteopenia. Conclusions. Sex hormones deficiency in men was significantly correlated with the decrease of BMD. Determination of serum Tf and E2 levels is important in assessing the risk of osteoporosis in male subjects.

Keywords

1. Rao SS, Budhwar N. Ashfaque A. Osteoporosis in men. Am Fam Physician. 2010 Sep 1;82(5):503-508.Search in Google Scholar

2. Herrera A, Lobo-Escolar A, Mateo J, Gil J, Ibarz E, Gracia L. Male osteoporosis: A review. World J Orthop. 2012 December 18;3(12):223-34. DOI: 10.5312/wjo.v3.i12.22310.5312/wjo.v3.i12.223Search in Google Scholar

3. Lambert JK, Zaidi M, Mechanick JI. Male osteoporosis: epidemiology and the pathogenesis of aging bones. Curr Osteoporos Rep. 2011 Dec;9(4):229-36. DOI: 10.1007/s11914-011-0066-z10.1007/s11914-011-0066-zSearch in Google Scholar

4. Meier C, Nguyen TV, Handelsman DJ, Schindler C, Kushnir MM, Rockwood AL, et al. Endogenous Sex Hormones and Incident Fracture Risk in Older Men. The Dubbo Osteoporosis Epidemiology Study. Arch Intern Med. 2008 Jan;168(1):47-54. DOI: 10.1001/archinternmed.2007.210.1001/archinternmed.2007.2Search in Google Scholar

5. Martin AC. Osteoporosis in men: a review of endogenous sex hormones and testosterone replacement therapy. J Pharm Pract. 2011 Jun; 24(3):307-15. DOI: 10.1177/089719001039771610.1177/0897190010397716Search in Google Scholar

6. Drake MT, Murad MH, Mauck KF, Lane MA, Undavalli C, Elraiyah T, et al. Clinical review. Risk factors for low bone mass-related fractures in men: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2012 Jun;97(6):1861-70. DOI: 10.1210/jc.2011-305810.1210/jc.2011-3058Search in Google Scholar

7. Frenkel B, Hong A, Baniwal SK, Coetzee GA, Ohlsson C, Khalid O, et al. Regulation of adult bone turnover by sexsteroids. J Cell Physiol. 2010;224(2):305–10. DOI: 10.1002/jcp.2215910.1002/jcp.22159Search in Google Scholar

8. Khosla S, Oursler MJ, Monroe DG. Estrogen and the skeleton. Trends Endocrin Met. 2012; 23(11):576–81. DOI: 10.1016/j.tem.2012.03.00810.1016/j.tem.2012.03.008Search in Google Scholar

9. Rochira V, Balestrieri A, Madeo B, Zirilli L, Granata ARM, Carani C. Osteoporosis and male age-related hypogonadism: role of sex steroids on bone (patho) physiology. Eur J Endocrinol. 2006 Febr;154(2):175–85. DOI: 10.1530/eje.1.0208810.1530/eje.1.02088Search in Google Scholar

10. Chin KY, Ima-Nirwana S. Sex Steroids and Bone Health Status in Men. Int J Endocrinol. 2012; 10:404-10. DOI: 10.1155/2012/20871910.1155/2012/208719Search in Google Scholar

11. Carnevale V, Romagnoli E, Cipriani C, Del Fiacco R, Piemonte S, Pepe J, et al. Sex hormones and bone health in males. Arch Biochem Biophys. 2010;503:110–7. DOI: 10.1016/j.abb.2010.07.00110.1016/j.abb.2010.07.001Search in Google Scholar

12. El Maghraoui A, Ouzzif Z, Mounach A, Ben-Ghabrit A, Achemlal L, Bezza A, et al. The relationship between sex steroids, bone turnover and vertebral fracture prevalence in asymptomatic men. Bone. 2011 Oct;49(4):853-7. DOI: 10.1016/j.bone.2011.06.02210.1016/j.bone.2011.06.022Search in Google Scholar

13. Ward KA, Pye SR, Adams JE. Influence of age and sex steroids on bone density and geometry in middle-aged and elderly European men. Osteoporos Int. 2011 May;22(5):1513–23. DOI: 10.1007/s00198-010-1437-510.1007/s00198-010-1437-5Search in Google Scholar

14. Barrett-Connor E, Mueller JE, von Mühlen DG, Laughlin GA, Schneider DL, Sartoris DJ. Low levels of estradiol are associated with vertebral fractures in older men, but not women: the Rancho Bernardo Study. J Clin Endocrinol Metab. 2000 Jan;85(1):219–23. DOI: 10.1210/jc.85.1.219 DOI: 10.1210/jcem.85.1.632710.1210/jc.85.1.219Search in Google Scholar

15. Finkelstein JS, Lee H, Burnett-Bowie SAM. Gonadal steroids and body composition, strength, and sexual function in men. N Engl J Med. 2013 Sep;369(11):1011–22. DOI: 10.1056/NEJMoa120616810.1056/NEJMoa1206168Search in Google Scholar

16. Mellstrom D, Johnell O, Ljunggren O, Eriksson AL, Lorentzon M, Mallmin H, et al. Free testosterone is an independent predictor of BMD and prevalent fractures in elderly men: MrOS Sweden. J Bone Miner Res. 2006 Apr;21(4):529-35. DOI: 10.1359/jbmr.06011010.1359/jbmr.060110Search in Google Scholar

17. Goderie-Plomp HW, van der Klift M, de Ronde W, Hofman A, de Jong FH & Pols HAP. Endogenous sex hormones, sex hormone binding globulin, and the risk of incident vertebral fractures in elderly men and women: the Rotterdam Study. J Clin Endocrinol Metab. 2004 Jul;89(7):3261-9. DOI: 10.1210/jc.2002-02204110.1210/jc.2002-022041Search in Google Scholar

18. Ree EJ, Oh KW, Lee WY, Kim SW, Oh ES, Baek KH, et al. Age, body mass index, current smoking history, and serum insulin-like growth factor-I levels associated with bone mineral density in middle-aged Korean men. J Bone Miner Metab. 2004;22(4):392-8. DOI: 10.1007/s00774-003-0500-010.1007/s00774-003-0500-0Search in Google Scholar

19. Compston J, Bowring C, Cooper A, Cooper C, Davies C, Francis R, et al. Guidelines for the diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG). Maturitas. 2013 Aug;75(4):392-6. DOI: 10.1016/j.maturitas.2013.05.01310.1016/j.maturitas.2013.05.013Search in Google Scholar

20. Gielen E, Vanderschueren D, Callewaert F, Boonen S. Osteoporosis in men. Best Practice and Research 2011; 25(2):321–35. DOI: 10.1016/j.beem.2010.08.01210.1016/j.beem.2010.08.012Search in Google Scholar

21. Khosla S. Update in male osteoporosis. J Clin Endocrinol Metab. 2010 Jan;95(1):3-10. DOI: 10.1210/jc.2009-174010.1210/jc.2009-1740Search in Google Scholar

22. Sutton RAL, Dian L, Guy P. Osteoporosis in men: An underrecognized and undertreated problem. BCMJ. 2011 Dec;53(10):535-40.Search in Google Scholar

23. Woo J, Kwok T, Leung JCS, Ohlsson C, Vandenput L, Leung PC. Sex steroids and bone health in older Chinese men. Osteoporosis International 2011; 23(5):1553–62. DOI: 10.1007/s00198-011-1552-y10.1007/s00198-011-1552-ySearch in Google Scholar

24. Bjornerem A, Emaus N, Berntsen GK, Joakimsen RM, Fonnebo V, Wilsgaard T, et al. Circulating sex steroids, sex hormone-binding globulin, and longitudinal changes in forearm bone mineral density in postmenopausal women and men: the Tromso study. Calcif Tissue Int. 2007 Aug;81(2):65-72. DOI: 10.1007/s00223-007-9035-z10.1007/s00223-007-9035-zSearch in Google Scholar

25. Cauley JA, Ewing SK, Taylor BC, Fink HA, Ensrud KE, Bauer DC, et al. Sex steroid hormones in older men: Longitudinal associations with 4.5-year change in hip bone mineral density—The Osteoporotic Fractures in Men Study (MrOs). J Clin Endocrinol Metab. 2010 Sep;95(9):4314-23. DOI: 10.1210/jc.2009-263510.1210/jc.2009-2635Search in Google Scholar

26. Keles I, Aydin G, Basar MM, Hairan M, Atalar E, Orkun S, et al. Endogenous sex steroids and bone mineral density in healthy men. Joint Bone Spine. 2006 Jan;73(1):80-5. DOI: 10.1016/j.jbspin.2005.04.00310.1016/j.jbspin.2005.04.003Search in Google Scholar

27. Venkat K, Desai M, Arora MM, Singh P, Khatkhatay MI. Age-related changes in sex steroid levels influence bone mineral density in healthy Indian men. Osteoporos Int. 2009 Jun; 20 (6):955-62. DOI: 10.1007/s00198-008-0765-110.1007/s00198-008-0765-1Search in Google Scholar

28. Amin S, Zhang Y, Felson DT, Sawin CT, Hannan MT, Wilson PV, et al. Estradiol, testosterone, and the risk for hip fractures in elderly men from the Framingham Study. Am J Med. 2006 May;119(5):426-33. DOI: 10.1016/j.amjmed.2005.10.04810.1016/j.amjmed.2005.10.048Search in Google Scholar

29. Vandenput L, Ohlsson C. Sex steroid metabolism in the regulation of bone health in men. J Steroid Biochem Mol Biol. 2010 Aug;121(3-5):582-88. DOI: 10.1016/j.jsbmb.2010.03.06710.1016/j.jsbmb.2010.03.067Search in Google Scholar

30. Paller CJ, Shielst MS, Rohrmann S, Basaria S, Rifai N, Nelson W, et al. Relationship of sex steroid hormones with bone mineral density (BMD) in a nationally representative sample of men. Clin Endocrinol (Oxf). 2009 Jan;70(1):26-34. DOI: 10.1111/j.1365-2265.2008.03300.x10.1111/j.1365-2265.2008.03300.xSearch in Google Scholar

31. Ensrud KE, Lewis CE, Lambert LC, Taylor BC, Fink HA, Barrett-Connor E, et al. Endogenous sex steroids, weight change and rates of hip bone loss in older men: the MrOS study. Osteoporos Int. 2006 Sep;17(9):1329-36. DOI: 10.1007/s00198-006-0088-z10.1007/s00198-006-0088-zSearch in Google Scholar

32. Araujo A, Travison TG, Leder BZ, McKinlay JB. Correlations between serum testosterone, estradiol, and sex hormone-binding globulin and bone mineral density in a diverse sample of men. J Clin Endocrinol Metab. 2008 Jun;93(6):2135-41. DOI: 10.1210/jc.2007-146910.1210/jc.2007-1469Search in Google Scholar

33. Fink HA, Ewing SK, Ensrud KE, Barett-Connor E, Taylor BC, Cauley JA, et al. Association of testosterone and estradiol deficiency with osteoporosis and rapid bone loss in older men. J Clin Endocrinol Metab. 2006 Oct;91(10):3908-15. DOI: 10.1210/jc.2006-017310.1210/jc.2006-0173Search in Google Scholar

Recommended articles from Trend MD

Plan your remote conference with Sciendo