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Free testosterone is an independent predictor of BMD and prevalent fractures in elderly men: MrOS Sweden

Mellstrom, D; Johnell, Olof LU ; Ljunggren, O; Eriksson, AL; Lorentzon, M; Mallmin, H; Holmberg, Anna H LU ; Redlund-Johnell, Inga LU ; Orwoll, E and Ohlsson, C (2006) In Journal of Bone and Mineral Research 21(4). p.529-535
Abstract
The role of androgens for bone health in elderly men is unclear. We show that free testosterone within the normal range is a predictor of BMD at predominantly cortical bone sites and of previous osteoporosis-related fractures in elderly Swedish men. Introduction: Osteoporosis-related fractures constitute a major health concern not only in women but also in men. Previous studies have clearly shown that serum levels of estradiol are associated with BMD, whereas more conflicting data have been presented regarding the predictive value of testosterone (T) for bone health in elderly men. The aim Of this Study was to investigate if serum levels of T are associated with BMD and/or prevalent fractures in a large cohort of elderly trien. Materials... (More)
The role of androgens for bone health in elderly men is unclear. We show that free testosterone within the normal range is a predictor of BMD at predominantly cortical bone sites and of previous osteoporosis-related fractures in elderly Swedish men. Introduction: Osteoporosis-related fractures constitute a major health concern not only in women but also in men. Previous studies have clearly shown that serum levels of estradiol are associated with BMD, whereas more conflicting data have been presented regarding the predictive value of testosterone (T) for bone health in elderly men. The aim Of this Study was to investigate if serum levels of T are associated with BMD and/or prevalent fractures in a large cohort of elderly trien. Materials and Methods: In the Swedish part of the MrOS study (n = 2908, average age, 75.4 years), bone parameters were measured using DXA, and prevalent fractures were recorded using standardized questionnaires and by vertebral X-ray analyses. Serum levels of total T, total estradiol (E2), and sex hormone-binding globulin (SHBG) were measured by radioimmunoassay, and free T (FT) and free E2 (FE2) were derived from the mass action equations. Height, weight, age, physical activity, smoking habits, and calcium intake were included together with FT and FE2 in regression models for BMD. Results:FT was an independent positive predictor of BMD in total body, total hip, femur trochanter, and arm but not in the lumbar spine. The highest independent predictive value of FT was found in the arm and the hip (with a relatively high content of cortical bone). FE2 was an independent predictor of BMD at all bone sites studied, and the highest predictive value was seen for lumbar spine (with relatively high content of trabecular bone) BMD. FT but not FE2 was a positive predictor of total body bone area and BMC. FT levels below the median were independent predictors of prevalent osteoporosis-related fractures (OR, 1.56; 95% CI, 1.14-2.14; p < 0.01.) and X-ray-verified vertebral fractures (OR, 2.00; 95% Cl, 1.34-2.86; p < 0.001). The predictive value of FT for prevalent fractures was not affected by adjustment for BMD. Conclusions: These findings show that variation of FT within the normal range is an independent but modest predictor of BMD at predominantly cortical bone sites and of previous osteoporosis-related fractures in elderly men. Our data indicate that not only estrogens but also androgens are of importance for bone health in elderly men. Longitudinal studies investigating the predictive value of T for fracture risk in elderly men are required. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
estradiol, fractures, BMD, testosterone
in
Journal of Bone and Mineral Research
volume
21
issue
4
pages
529 - 535
publisher
AMBMR
external identifiers
  • pmid:16598372
  • wos:000236343800006
  • scopus:33645333405
ISSN
1523-4681
DOI
10.1359/jbmr.060110
language
English
LU publication?
yes
id
2b9508a3-d292-479a-b93a-05c4d505030c (old id 415160)
date added to LUP
2007-10-10 12:14:56
date last changed
2019-10-13 03:38:58
@article{2b9508a3-d292-479a-b93a-05c4d505030c,
  abstract     = {The role of androgens for bone health in elderly men is unclear. We show that free testosterone within the normal range is a predictor of BMD at predominantly cortical bone sites and of previous osteoporosis-related fractures in elderly Swedish men. Introduction: Osteoporosis-related fractures constitute a major health concern not only in women but also in men. Previous studies have clearly shown that serum levels of estradiol are associated with BMD, whereas more conflicting data have been presented regarding the predictive value of testosterone (T) for bone health in elderly men. The aim Of this Study was to investigate if serum levels of T are associated with BMD and/or prevalent fractures in a large cohort of elderly trien. Materials and Methods: In the Swedish part of the MrOS study (n = 2908, average age, 75.4 years), bone parameters were measured using DXA, and prevalent fractures were recorded using standardized questionnaires and by vertebral X-ray analyses. Serum levels of total T, total estradiol (E2), and sex hormone-binding globulin (SHBG) were measured by radioimmunoassay, and free T (FT) and free E2 (FE2) were derived from the mass action equations. Height, weight, age, physical activity, smoking habits, and calcium intake were included together with FT and FE2 in regression models for BMD. Results:FT was an independent positive predictor of BMD in total body, total hip, femur trochanter, and arm but not in the lumbar spine. The highest independent predictive value of FT was found in the arm and the hip (with a relatively high content of cortical bone). FE2 was an independent predictor of BMD at all bone sites studied, and the highest predictive value was seen for lumbar spine (with relatively high content of trabecular bone) BMD. FT but not FE2 was a positive predictor of total body bone area and BMC. FT levels below the median were independent predictors of prevalent osteoporosis-related fractures (OR, 1.56; 95% CI, 1.14-2.14; p &lt; 0.01.) and X-ray-verified vertebral fractures (OR, 2.00; 95% Cl, 1.34-2.86; p &lt; 0.001). The predictive value of FT for prevalent fractures was not affected by adjustment for BMD. Conclusions: These findings show that variation of FT within the normal range is an independent but modest predictor of BMD at predominantly cortical bone sites and of previous osteoporosis-related fractures in elderly men. Our data indicate that not only estrogens but also androgens are of importance for bone health in elderly men. Longitudinal studies investigating the predictive value of T for fracture risk in elderly men are required.},
  author       = {Mellstrom, D and Johnell, Olof and Ljunggren, O and Eriksson, AL and Lorentzon, M and Mallmin, H and Holmberg, Anna H and Redlund-Johnell, Inga and Orwoll, E and Ohlsson, C},
  issn         = {1523-4681},
  keyword      = {estradiol,fractures,BMD,testosterone},
  language     = {eng},
  number       = {4},
  pages        = {529--535},
  publisher    = {AMBMR},
  series       = {Journal of Bone and Mineral Research},
  title        = {Free testosterone is an independent predictor of BMD and prevalent fractures in elderly men: MrOS Sweden},
  url          = {http://dx.doi.org/10.1359/jbmr.060110},
  volume       = {21},
  year         = {2006},
}