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Sex hormone status and bone metabolism in men with Crohn's disease.

Abstract

BACKGROUND

Men with Crohn's disease (CD) are at risk of osteoporosis, but the factors contributing to low bone mineral density and its optimum treatment have not been established.

AIM

To investigate the sex hormone status of men with CD, and to establish the influence of sex hormones on their bone metabolism.

METHODS

Bone density was measured by dual energy X-ray absorptiometry at the hip and lumbar spine in 48 men with CD. Total serum testosterone and gonadotrophins were measured in all subjects and the free androgen index calculated in men with low or borderline total testosterone. Serum osteocalcin, pro-collagen carboxy-terminal peptide, bone specific alkaline phosphatase and urinary deoxypyridinoline were measured as markers of bone turnover.

RESULTS

Eight (17%) men had osteoporosis, and a further 14 (29%) had osteopenia. Three (6%) men had a low free androgen index and normal gonadotrophins consistent with secondary hypogonadism, two of whom had osteopenia of the hip and spine. Age (P = 0.002) and small bowel Crohn's disease (P = 0.02) were the only independent predictors of serum testosterone. There was a significant association between total testosterone and osteocalcin (r = 0.53, 95%, CI: 0.29-0.71, P = 0.0001) which was independent of age and current steroid use (P = 0.0001).

CONCLUSIONS

Previously undiagnosed hypogonadism is an uncommon cause of low bone density in men with CD. The independent association between testosterone and the bone formation marker osteocalcin suggests sex hormone status influences bone metabolism in men with CD. The results suggest testosterone replacement might be effective treatment for some men with osteoporosis and Crohn's disease.

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  • Authors+Show Affiliations

    ,

    Gastrointestinal Research Unit, Leicester General Hospital, UK.

    , , ,

    Source

    MeSH

    Absorptiometry, Photon
    Adult
    Aged
    Biomarkers
    Bone Density
    Bone Diseases, Metabolic
    Crohn Disease
    Gonadotropins
    Hip
    Humans
    Hypogonadism
    Lumbar Vertebrae
    Male
    Middle Aged
    Osteoporosis
    Regression Analysis
    Testosterone

    Pub Type(s)

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

    Language

    eng

    PubMed ID

    9692696

    Citation

    Robinson, R J., et al. "Sex Hormone Status and Bone Metabolism in Men With Crohn's Disease." Alimentary Pharmacology & Therapeutics, vol. 12, no. 1, 1998, pp. 21-5.
    Robinson RJ, Iqbal SJ, Al-Azzawi F, et al. Sex hormone status and bone metabolism in men with Crohn's disease. Aliment Pharmacol Ther. 1998;12(1):21-5.
    Robinson, R. J., Iqbal, S. J., Al-Azzawi, F., Abrams, K., & Mayberry, J. F. (1998). Sex hormone status and bone metabolism in men with Crohn's disease. Alimentary Pharmacology & Therapeutics, 12(1), pp. 21-5.
    Robinson RJ, et al. Sex Hormone Status and Bone Metabolism in Men With Crohn's Disease. Aliment Pharmacol Ther. 1998;12(1):21-5. PubMed PMID: 9692696.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Sex hormone status and bone metabolism in men with Crohn's disease. AU - Robinson,R J, AU - Iqbal,S J, AU - Al-Azzawi,F, AU - Abrams,K, AU - Mayberry,J F, PY - 1998/8/6/pubmed PY - 1998/8/6/medline PY - 1998/8/6/entrez SP - 21 EP - 5 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 12 IS - 1 N2 - BACKGROUND: Men with Crohn's disease (CD) are at risk of osteoporosis, but the factors contributing to low bone mineral density and its optimum treatment have not been established. AIM: To investigate the sex hormone status of men with CD, and to establish the influence of sex hormones on their bone metabolism. METHODS: Bone density was measured by dual energy X-ray absorptiometry at the hip and lumbar spine in 48 men with CD. Total serum testosterone and gonadotrophins were measured in all subjects and the free androgen index calculated in men with low or borderline total testosterone. Serum osteocalcin, pro-collagen carboxy-terminal peptide, bone specific alkaline phosphatase and urinary deoxypyridinoline were measured as markers of bone turnover. RESULTS: Eight (17%) men had osteoporosis, and a further 14 (29%) had osteopenia. Three (6%) men had a low free androgen index and normal gonadotrophins consistent with secondary hypogonadism, two of whom had osteopenia of the hip and spine. Age (P = 0.002) and small bowel Crohn's disease (P = 0.02) were the only independent predictors of serum testosterone. There was a significant association between total testosterone and osteocalcin (r = 0.53, 95%, CI: 0.29-0.71, P = 0.0001) which was independent of age and current steroid use (P = 0.0001). CONCLUSIONS: Previously undiagnosed hypogonadism is an uncommon cause of low bone density in men with CD. The independent association between testosterone and the bone formation marker osteocalcin suggests sex hormone status influences bone metabolism in men with CD. The results suggest testosterone replacement might be effective treatment for some men with osteoporosis and Crohn's disease. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/9692696/Sex_hormone_status_and_bone_metabolism_in_men_with_Crohn's_disease_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0269-2813&date=1998&volume=12&issue=1&spage=21 DB - PRIME DP - Unbound Medicine ER -