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Endogenous sex hormones and incident fracture risk in older men: the Dubbo Osteoporosis Epidemiology Study.

Abstract

BACKGROUND

Data on the influence of gonadal hormones on incident fracture risk in elderly men are limited. We prospectively examined the relationship between serum levels of testosterone and estradiol and future fracture risk in community-dwelling men.

METHODS

A total of 609 men older than 60 years had been observed between January 1989 and December 2005, with the median duration being 5.8 years (up to 13 years). Clinical risk factors, including bone mineral density and lifestyle factors, were assessed at baseline. Serum testosterone and estradiol levels were measured by tandem mass spectrometry. The incidence of a low-trauma fracture was ascertained during follow-up.

RESULTS

During follow-up, 113 men had at least 1 low-trauma fracture. The risk of fracture was significantly increased in men with reduced testosterone levels (hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.09-1.62). After adjustment for sex hormone-binding globulin, serum testosterone (HR, 1.48; 95% CI, 1.22-1.78) and serum estradiol (HR, 1.21; 95% CI, 1.00-1.47) levels were associated with overall fracture risk. After further adjustment for major risk factors of fractures (age, weight or bone mineral density, fracture history, smoking status, calcium intake, and sex hormone-binding globulin), lower testosterone was still associated with increased risk of fracture, particularly with hip (HR, 1.88; 95% CI, 1.24-2.82) and nonvertebral (HR, 1.32; 95% CI, 1.03-1.68) fractures.

CONCLUSION

In community-dwelling men older than 60 years, serum testosterone is independently associated with the risk of osteoporotic fracture and its measurement may provide additional clinical information for the assessment of fracture risk in elderly men.

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  • Authors+Show Affiliations

    ,

    Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Basel, Switzerland. christian.meier@unibas.ch

    , , , , , , , ,

    Source

    Archives of internal medicine 168:1 2008 Jan 14 pg 47-54

    MeSH

    Aged
    Bone Density
    Estradiol
    Follow-Up Studies
    Fractures, Bone
    Humans
    Incidence
    Life Style
    Male
    Middle Aged
    Osteoporosis
    Prospective Studies
    Risk Factors
    Testosterone

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    18195195

    Citation

    Meier, Christian, et al. "Endogenous Sex Hormones and Incident Fracture Risk in Older Men: the Dubbo Osteoporosis Epidemiology Study." Archives of Internal Medicine, vol. 168, no. 1, 2008, pp. 47-54.
    Meier C, Nguyen TV, Handelsman DJ, et al. Endogenous sex hormones and incident fracture risk in older men: the Dubbo Osteoporosis Epidemiology Study. Arch Intern Med. 2008;168(1):47-54.
    Meier, C., Nguyen, T. V., Handelsman, D. J., Schindler, C., Kushnir, M. M., Rockwood, A. L., ... Seibel, M. J. (2008). Endogenous sex hormones and incident fracture risk in older men: the Dubbo Osteoporosis Epidemiology Study. Archives of Internal Medicine, 168(1), pp. 47-54. doi:10.1001/archinternmed.2007.2.
    Meier C, et al. Endogenous Sex Hormones and Incident Fracture Risk in Older Men: the Dubbo Osteoporosis Epidemiology Study. Arch Intern Med. 2008 Jan 14;168(1):47-54. PubMed PMID: 18195195.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Endogenous sex hormones and incident fracture risk in older men: the Dubbo Osteoporosis Epidemiology Study. AU - Meier,Christian, AU - Nguyen,Tuan V, AU - Handelsman,David J, AU - Schindler,Christian, AU - Kushnir,Mark M, AU - Rockwood,Alan L, AU - Meikle,A Wayne, AU - Center,Jacqueline R, AU - Eisman,John A, AU - Seibel,Markus J, PY - 2008/1/16/pubmed PY - 2008/2/26/medline PY - 2008/1/16/entrez SP - 47 EP - 54 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 168 IS - 1 N2 - BACKGROUND: Data on the influence of gonadal hormones on incident fracture risk in elderly men are limited. We prospectively examined the relationship between serum levels of testosterone and estradiol and future fracture risk in community-dwelling men. METHODS: A total of 609 men older than 60 years had been observed between January 1989 and December 2005, with the median duration being 5.8 years (up to 13 years). Clinical risk factors, including bone mineral density and lifestyle factors, were assessed at baseline. Serum testosterone and estradiol levels were measured by tandem mass spectrometry. The incidence of a low-trauma fracture was ascertained during follow-up. RESULTS: During follow-up, 113 men had at least 1 low-trauma fracture. The risk of fracture was significantly increased in men with reduced testosterone levels (hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.09-1.62). After adjustment for sex hormone-binding globulin, serum testosterone (HR, 1.48; 95% CI, 1.22-1.78) and serum estradiol (HR, 1.21; 95% CI, 1.00-1.47) levels were associated with overall fracture risk. After further adjustment for major risk factors of fractures (age, weight or bone mineral density, fracture history, smoking status, calcium intake, and sex hormone-binding globulin), lower testosterone was still associated with increased risk of fracture, particularly with hip (HR, 1.88; 95% CI, 1.24-2.82) and nonvertebral (HR, 1.32; 95% CI, 1.03-1.68) fractures. CONCLUSION: In community-dwelling men older than 60 years, serum testosterone is independently associated with the risk of osteoporotic fracture and its measurement may provide additional clinical information for the assessment of fracture risk in elderly men. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/18195195/Endogenous_sex_hormones_and_incident_fracture_risk_in_older_men:_the_Dubbo_Osteoporosis_Epidemiology_Study_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinternmed.2007.2 DB - PRIME DP - Unbound Medicine ER -