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The CAG repeat polymorphism in the androgen receptor gene affects bone density and bone metabolism in healthy males
Abstract
OBJECTIVE Bone metabolism and bone density (BD) are influenced by sex hormones. Testosterone (T) action is exerted through the androgen receptor (AR). We investigated the potential impact of the CAG repeat (CAGR) polymorphism within the AR gene on BD and bone metabolism in healthy younger males. PATIENTS AND MEASUREMENTS The number of CAGRs in 110 healthy men aged 20–50 years was determined by sequence analysis. We assessed BD by the radiation‐free method of quantitative ultrasound (QUS) of the phalanges. Serum levels of bone‐specific alkaline phosphatase (BAP) and urine secretion of free deoxypyridinoline (DPD, corrected for creatinine), serum levels of sex hormones, body fat content and lifestyle factors were determined. RESULTS In stepwise multiple regression models controlling for age, body fat content and lifestyle factors, the number of CAGRs was an independent negative predictor of BD (partial r = − 0·286, P = 0·001), whereas it was positively associated with markers of bone turnover (for BAP: partial r = 0·32, P = 0·001; for DPD: partial r = 0·241, P = 0·013). Levels of free T and oestradiol showed an independent and positive association with BD; age contributed significantly to lower BD. Age and free T were negatively associated with markers of bone turnover, whereas oestradiol showed a positive correlation with BAP and DPD. anova in groups according to age and the CAGR length suggested an increased age‐dependent bone loss in subjects with a CAGR length of 22–31 compared with 14–21 CAGRs (overall P < 0·01). CONCLUSIONS A high number of CAG repeats within the androgen receptor gene attenuates testosterone effects on bone density and bone metabolism. This seems to be associated with accelerated age‐dependent bone loss.
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“Results demonstrated findings similar to those observed in men with low T, including depressed mood, anxiety, impaired spermatogenesis, and loss of bone mineral density (BMD), among others.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [32]
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“as well as bone (62) and sperm production (63) within the”
Zitzmann, M., Depenbusch, M., Gromoll, J., & Nieschlag, E. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2004-1424 · Cited by 231
“(18, 19); mood/cognition (20, 21); and sperm concentrations”
MethodSelf-citationThe CAG repeat polymorphism within the androgen receptor gene and maleness1
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Self-citationTestosterone for the aging male; current evidence and recommended practice
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“A receptor with a short CAG sequence produces greater activity when androgens attach, and men with shorter CAG polymorphisms exhibit androgenic traits, such as preserved bone density (Zitzmann et al 2001) and prostate growth during testosterone treatment (Zitzmann et al 2003).”
Metadata
- Authors
- Zitzmann, M., Brune, M., Kornmann, B., Gromoll, J., Junker, R., & Nieschlag, E.
- Affiliations
- University of Münster (DE)
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2001-11
- Volume
- 55
- Issue
- 5
- Pages
- 649-657
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W2017076191
- Cited by
- 107
- References
- 51
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 1 · 2016: 4 · 2015: 2 · 2014: 3 · 2013: 6 · 2012: 4
- FWCI
- 9.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- 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 › Sexual Differentiation and Disorders
- Keywords
- androgen receptor gene, CAG repeat polymorphism, bone mineral density, bone metabolism, bone turnover markers, bone-specific alkaline phosphatase, deoxypyridinoline, testosterone, estradiol, age-related bone loss, healthy young men
- MeSH terms
- Adult, Aging, Alkaline Phosphatase, Amino Acids, Analysis of Variance, Body Constitution, Bone and Bones, Estradiol, Humans, Male, Middle Aged, Polymorphism, Genetic, Receptors, Androgen, Sex Hormone-Binding Globulin, Testosterone, Biomarkers, Bone Density, Trinucleotide Repeats
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