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Relationship of volumetric BMD and structural parameters at different skeletal sites to sex steroid levels in men.
J Bone Miner Res. 2005 May; 20(5):730-40.JB

Abstract

In a population-based, cross-sectional study, we related age-associated changes in vBMD and in bone structural parameters to circulating bioavailable estradiol and testosterone levels in men. Associations between these bone mass/structural parameters and sex steroid levels were progressively stronger with age. Our previously postulated "threshold" for skeletal estrogen deficiency was most evident at cortical sites.

INTRODUCTION

Serum sex steroids, particularly estrogen levels, are associated with bone mass in men, and previous work has suggested that there may be a "threshold" bioavailable estradiol (bio E(2)) level below which the male skeleton becomes estrogen deficient. However, previous studies addressing this issue have exclusively used DXA, which cannot separate trabecular from cortical bone or provide information on bone geometry or structure.

MATERIALS AND METHODS

In an age-stratified population sample of 314 men (age, 22-91 years), we assessed volumetric BMD (vBMD) and bone geometry by QCT at the lumbar spine, femoral neck, distal radius, and distal tibia and related these to circulating bio E(2) and bio testosterone (T) levels.

RESULTS

Compared with young men (age, 20-39 years), middle-aged men (age, 40-59 years) had significantly lower bio T (-26%, p < 0.001) and bio E(2) (-9%, p = 0.038) levels, and these decreases were even greater in the elderly men (age > or = 60 years, -60% and -38% for bio T and bio E(2), respectively, p < 0.001 for both). Reflecting their intact gonadal status, vBMD/structural parameters were not related to sex steroid levels in young men, whereas bio E(2) levels were associated consistently with vBMD and variably with bone geometric parameters in the elderly men; middle-aged men showed associations with bio E(2) and bio T at some sites. At all cortical sites, vBMD was associated with bio E(2) at low (<30 pM, R = 0.27-0.41, p < 0.05-0.001) but not high (> or =30 pM, R = -0.003 to 0.12, p = not significant) levels; no such differences were evident at trabecular sites.

CONCLUSIONS

In men, bio E(2) is the most consistent predictor of vBMD and some bone geometric variables as assessed by QCT. We also extend our previous findings on a possible "threshold" for skeletal estrogen deficiency by showing that this is most evident for cortical sites.

Authors+Show Affiliations

Endocrine Research Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA. khosla.sundeep@mayo.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15824845

Citation

Khosla, Sundeep, et al. "Relationship of Volumetric BMD and Structural Parameters at Different Skeletal Sites to Sex Steroid Levels in Men." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 20, no. 5, 2005, pp. 730-40.
Khosla S, Melton LJ, Robb RA, et al. Relationship of volumetric BMD and structural parameters at different skeletal sites to sex steroid levels in men. J Bone Miner Res. 2005;20(5):730-40.
Khosla, S., Melton, L. J., Robb, R. A., Camp, J. J., Atkinson, E. J., Oberg, A. L., Rouleau, P. A., & Riggs, B. L. (2005). Relationship of volumetric BMD and structural parameters at different skeletal sites to sex steroid levels in men. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 20(5), 730-40.
Khosla S, et al. Relationship of Volumetric BMD and Structural Parameters at Different Skeletal Sites to Sex Steroid Levels in Men. J Bone Miner Res. 2005;20(5):730-40. PubMed PMID: 15824845.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship of volumetric BMD and structural parameters at different skeletal sites to sex steroid levels in men. AU - Khosla,Sundeep, AU - Melton,L Joseph,3rd AU - Robb,Richard A, AU - Camp,Jon J, AU - Atkinson,Elizabeth J, AU - Oberg,Ann L, AU - Rouleau,Peggy A, AU - Riggs,B Lawrence, Y1 - 2004/12/20/ PY - 2004/08/23/received PY - 2004/12/03/revised PY - 2004/12/15/accepted PY - 2005/4/13/pubmed PY - 2005/8/20/medline PY - 2005/4/13/entrez SP - 730 EP - 40 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J Bone Miner Res VL - 20 IS - 5 N2 - UNLABELLED: In a population-based, cross-sectional study, we related age-associated changes in vBMD and in bone structural parameters to circulating bioavailable estradiol and testosterone levels in men. Associations between these bone mass/structural parameters and sex steroid levels were progressively stronger with age. Our previously postulated "threshold" for skeletal estrogen deficiency was most evident at cortical sites. INTRODUCTION: Serum sex steroids, particularly estrogen levels, are associated with bone mass in men, and previous work has suggested that there may be a "threshold" bioavailable estradiol (bio E(2)) level below which the male skeleton becomes estrogen deficient. However, previous studies addressing this issue have exclusively used DXA, which cannot separate trabecular from cortical bone or provide information on bone geometry or structure. MATERIALS AND METHODS: In an age-stratified population sample of 314 men (age, 22-91 years), we assessed volumetric BMD (vBMD) and bone geometry by QCT at the lumbar spine, femoral neck, distal radius, and distal tibia and related these to circulating bio E(2) and bio testosterone (T) levels. RESULTS: Compared with young men (age, 20-39 years), middle-aged men (age, 40-59 years) had significantly lower bio T (-26%, p < 0.001) and bio E(2) (-9%, p = 0.038) levels, and these decreases were even greater in the elderly men (age > or = 60 years, -60% and -38% for bio T and bio E(2), respectively, p < 0.001 for both). Reflecting their intact gonadal status, vBMD/structural parameters were not related to sex steroid levels in young men, whereas bio E(2) levels were associated consistently with vBMD and variably with bone geometric parameters in the elderly men; middle-aged men showed associations with bio E(2) and bio T at some sites. At all cortical sites, vBMD was associated with bio E(2) at low (<30 pM, R = 0.27-0.41, p < 0.05-0.001) but not high (> or =30 pM, R = -0.003 to 0.12, p = not significant) levels; no such differences were evident at trabecular sites. CONCLUSIONS: In men, bio E(2) is the most consistent predictor of vBMD and some bone geometric variables as assessed by QCT. We also extend our previous findings on a possible "threshold" for skeletal estrogen deficiency by showing that this is most evident for cortical sites. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/15824845/Relationship_of_volumetric_BMD_and_structural_parameters_at_different_skeletal_sites_to_sex_steroid_levels_in_men_ L2 - https://doi.org/10.1359/JBMR.041228 DB - PRIME DP - Unbound Medicine ER -