RESEARCH - Low testosterone a risk factor for osteoporotic fractures in older men

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Low testosterone a risk factor for osteoporotic fractures in older men

By Reuters Health

January 15, 2008

NEW YORK (Reuters Health), Jan 15 - In men age 60 years and older, low

circulating levels of testosterone are associated with increased risk of

low-trauma fractures, results of a prospective study suggest.

Inconsistent findings in previous research into the relationship between

serum testosterone levels and incident fracture risk may have been caused by

the use of immunoassays that are now known to be unreliable, Dr. Christian

Meier and colleagues note in the Archives of Internal Medicine for January

14.

In the Dubbo Osteoporosis Epidemiology Study, endogenous sex hormone levels

were measured by tandem mass spectrometry. The current analysis includes 609

men prospectively followed for about six years (maximum 12.6 years)

following baseline assessment. A total of 149 incident low-trauma,

clinically symptomatic fractures occurred in 113 men.

Dr. Meier, at the University of Sydney in New South Wales, Australia, and

colleagues found that serum testosterone levels were significantly lower

among men with fractures (400 versus 435 ng/dL, p = 0.004).

After controlling for major risk factors for fractures (age, weight, bone

mineral density, prior fracture, smoking, dietary calcium, and sex

hormone-binding globulin level), lower testosterone remained an independent

risk factor for osteoporotic fracture with an adjusted hazard ratio of 1.28

for each standard deviation decrease in serum testosterone (p = 0.02).

Further analysis showed that for men with testosterone levels < 294 ng/dL,

the risk of fracture was more than doubled in comparison with men with

higher concentrations.

" Measurement of serum testosterone provides additional clinical information

for the assessment of fracture risk in elderly men, " Dr. Meier and

colleagues conclude.

Last Updated: 2008-01-15 9:40:46 -0400 (Reuters Health)

Arch Intern Med 2008;168:47-54.

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