Endogenous Sex Hormones and Incident Fracture Risk in Older Men<subtitle>The Dubbo Osteoporosis Epidemiology Study</subtitle>
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-dwel…
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Associations between total T levels and low bone density have been reported, but results are conflicting.
“Interestingly, associations between total T levels and low bone density have been reported, but results are conflicting [146, 160–162].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [161]
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- Authors
- Meier, C.
- Affiliations
- University Hospital of Basel (CH)
- Corresponding author
- Meier, Christian
- ORCID
- Meier, Christian
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2008-01-14
- Volume
- 168
- Issue
- 1
- Pages
- 47
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2070698531
- Cited by
- 274
- References
- 4
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 8 · 2023: 6 · 2022: 9 · 2021: 13 · 2020: 11 · 2019: 10 · 2018: 11 · 2017: 7 · 2016: 10 · 2015: 17 · 2014: 15 · 2013: 17 · 2012: 22
- FWCI
- 33.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- UTS ePRESS (University of Technology Sydney) (submittedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- testosterone, estradiol, sex hormones, osteoporotic fractures, hip fracture, non-vertebral fractures, older men, fracture risk, sex hormone-binding globulin, bone mineral density, fragility fractures
- MeSH terms
- Aged, Estradiol, Follow-Up Studies, Humans, Life Style, Male, Middle Aged, Osteoporosis, Prospective Studies, Risk Factors, Testosterone, Bone Density, Incidence, Fractures, Bone
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