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Low serum levels of testosterone in men with minimal traumatic hip fractures.
Exp Clin Endocrinol Diabetes. 2005 Apr; 113(4):208-13.EC

Abstract

Sex steroids are essential for accretion and maintenance of bone mass. Their importance for osteoporotic fractures in men, however, are undefined. We determined circulating levels of testosterone (T), non-SHBG-bound T (bT), free testosterone (FT), oestradiol (E2), intact parathormone (iPTH), 25-OH-vitamin D (25(OH)D), and trabecular bone mineral density at spinal level (tBMD) by single quantitative computed tomography (QCT), respectively, in elderly men 1-3.5 months after minimal traumatic hip fractures (MTHF, age=75+/-10 ys, n=27). A group of patients with non-immobilising stroke (S; age=73+/-8 ys, n=12) served as controls. Men with known secondary osteoporosis were excluded from the study. Furthermore, serum levels of T and E2 were compared to healthy controls aged 20-30 years (n=138) and 60-80 years (n=110). In addition a literature-based analysis of studies on testosterone in men hip fractures were conducted. Mean tBMD of men with MTFH (52.7+/-17.6 mg/cm3, T-score=- 4.5+/-0.6) was significantly lower than in men with S (78+/-16.3 mg/cm3, T-score=- 3.5+/-0.8). Significant differences of the means between both groups were observed for T, bT, and FT but not for E2, 25(OH)D, and iPTH, respectively. About 90 % of men with MTHF had T serum levels 2 SD below the mean of young controls. This proportion reduced to 30 % if compared with serum levels of 60-80-year-old healthy men whereas men after S remained well within the normal range adjusted for age. Mean serum levels of iPTH were within the normal range (1-6.8 pmol/l); 25(OH)D serum levels were at the lower end of the normal control levels (30-190 nmol/l). There was an inverse relationship between iPTH and 25(OH)D (r=- 0,4; p<0,03). In conclusion, low serum T is common in men with MTHF and only partly due to age. It appears to be a primary factor in fragility fractures in men and not simply secondary to morbidity following the fracture. In view of the scarce and inconsistent data published on this issue (1 longitudinal and 6 cross-sectional studies) the present study supports the patho-physiological relevance of low serum testosterone for the occurrence of MTHF in men.

Authors+Show Affiliations

Leifke E
Devision of Gastroenterology, Hepatology and Endocrinology, MHH, Hannover, Germany. eckhard.leifke@schering.de
Wichers C
No affiliation info available
Gorenoi V
No affiliation info available
Lucke P
No affiliation info available
von zur Mühlen A
No affiliation info available
Brabant G
No affiliation info available

MeSH

AgedBone DensityCase-Control StudiesCross-Sectional StudiesEstradiolHip FracturesHumansMaleMiddle AgedParathyroid HormoneReference ValuesSpineTestosteroneWounds and Injuries

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15891956

Citation

Leifke, E, et al. "Low Serum Levels of Testosterone in Men With Minimal Traumatic Hip Fractures." Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association, vol. 113, no. 4, 2005, pp. 208-13.
Leifke E, Wichers C, Gorenoi V, et al. Low serum levels of testosterone in men with minimal traumatic hip fractures. Exp Clin Endocrinol Diabetes. 2005;113(4):208-13.
Leifke, E., Wichers, C., Gorenoi, V., Lucke, P., von zur Mühlen, A., & Brabant, G. (2005). Low serum levels of testosterone in men with minimal traumatic hip fractures. Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association, 113(4), 208-13.
Leifke E, et al. Low Serum Levels of Testosterone in Men With Minimal Traumatic Hip Fractures. Exp Clin Endocrinol Diabetes. 2005;113(4):208-13. PubMed PMID: 15891956.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low serum levels of testosterone in men with minimal traumatic hip fractures. AU - Leifke,E, AU - Wichers,C, AU - Gorenoi,V, AU - Lucke,P, AU - von zur Mühlen,A, AU - Brabant,G, PY - 2005/5/14/pubmed PY - 2005/9/27/medline PY - 2005/5/14/entrez SP - 208 EP - 13 JF - Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association JO - Exp Clin Endocrinol Diabetes VL - 113 IS - 4 N2 - Sex steroids are essential for accretion and maintenance of bone mass. Their importance for osteoporotic fractures in men, however, are undefined. We determined circulating levels of testosterone (T), non-SHBG-bound T (bT), free testosterone (FT), oestradiol (E2), intact parathormone (iPTH), 25-OH-vitamin D (25(OH)D), and trabecular bone mineral density at spinal level (tBMD) by single quantitative computed tomography (QCT), respectively, in elderly men 1-3.5 months after minimal traumatic hip fractures (MTHF, age=75+/-10 ys, n=27). A group of patients with non-immobilising stroke (S; age=73+/-8 ys, n=12) served as controls. Men with known secondary osteoporosis were excluded from the study. Furthermore, serum levels of T and E2 were compared to healthy controls aged 20-30 years (n=138) and 60-80 years (n=110). In addition a literature-based analysis of studies on testosterone in men hip fractures were conducted. Mean tBMD of men with MTFH (52.7+/-17.6 mg/cm3, T-score=- 4.5+/-0.6) was significantly lower than in men with S (78+/-16.3 mg/cm3, T-score=- 3.5+/-0.8). Significant differences of the means between both groups were observed for T, bT, and FT but not for E2, 25(OH)D, and iPTH, respectively. About 90 % of men with MTHF had T serum levels 2 SD below the mean of young controls. This proportion reduced to 30 % if compared with serum levels of 60-80-year-old healthy men whereas men after S remained well within the normal range adjusted for age. Mean serum levels of iPTH were within the normal range (1-6.8 pmol/l); 25(OH)D serum levels were at the lower end of the normal control levels (30-190 nmol/l). There was an inverse relationship between iPTH and 25(OH)D (r=- 0,4; p<0,03). In conclusion, low serum T is common in men with MTHF and only partly due to age. It appears to be a primary factor in fragility fractures in men and not simply secondary to morbidity following the fracture. In view of the scarce and inconsistent data published on this issue (1 longitudinal and 6 cross-sectional studies) the present study supports the patho-physiological relevance of low serum testosterone for the occurrence of MTHF in men. SN - 0947-7349 UR - https://www.unboundmedicine.com/medline/citation/15891956/Low_serum_levels_of_testosterone_in_men_with_minimal_traumatic_hip_fractures_ DB - PRIME DP - Unbound Medicine ER -