Association of Testosterone and Estradiol Deficiency with Osteoporosis and Rapid Bone Loss in Older Men
Abstract
Context The clinical value of measuring testosterone and estradiol in older men with osteoporosis and of measuring bone mineral density (BMD) in older men with testosterone or estradiol deficiency is uncertain. Objective The objective of the study was to examine the association of testosterone and estradiol deficiency with osteoporosis and rapid bone loss in older men. Design This study was a cross-sectional and longitudinal analysis. Setting The study was conducted at six U.S. centers of the Osteoporotic Fractures in Men study. Participants The study population consisted of 2447 community-dwelling men aged 65 yr or older. Main outcome measures Total testosterone deficiency was defined as less than 200 ng/dl. Total estradiol deficiency was defined as less than 10 pg/ml. Osteoporosis was defined as femoral neck or total hip BMD T-score of -2.5 or less. Rapid bone loss was defined as 3%/yr or more. Results Prevalence of osteoporosis in men with deficient and normal total testosterone was 12.3 and 6.0% (P = 0.003) and 15.4 and 2.8% (P Conclusions Older men with total testosterone or estradiol deficiency were more likely to be osteoporotic. Those with osteoporosis were more likely to be total testosterone or estradiol deficient. Rapid hip bone loss was more likely in men with total testosterone deficiency. BMD testing of older men with sex steroid deficiency may be clinically warranted.
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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 [162]
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- Authors
- Fink, H. A., Ewing, S. K., Ensrud, K. E., Barrett-Connor, E., Taylor, B. C., Cauley, J. A., & Orwoll, E. S.
- Affiliations
- University of Minnesota (US)
- University of California, San Francisco (US)
- University of California San Diego (US)
- Minneapolis VA Medical Center (US)
- University of Pittsburgh (US)
- Oregon Health & Science University (US)
- Corresponding author
- Fink, Howard A.
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2006-10
- Volume
- 91
- Issue
- 10
- Pages
- 3908-3915
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2067325834
- Cited by
- 319
- References
- 5
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 11 · 2023: 14 · 2022: 17 · 2021: 11 · 2020: 14 · 2019: 16 · 2018: 15 · 2017: 12 · 2016: 11 · 2015: 14 · 2014: 29 · 2013: 27 · 2012: 24
- FWCI
- 10.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs (U01 AR45580, U01 AR45583, U01 AR45647, U01 AR45632, U01 AG18197, U01 AR45614, U01 AR45654)
- National Institutes of Health
- National Institute on Aging (U01 AR45580, U01-AG-18197, U01AG018197, U01 AR45632, U01 AR45654, U01 AR45614, U01 AR45583, U01 AR45647)
- National Cancer Institute
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (U01AR45614, U01-AR45632, U01 AR45647, U01AR045583, U01 AR-45583, U01-AR-45654, U01AR045580, U01AR045632, U01AR045654, U01AR045614, U01AR045647, U01 AG18197, U01AR45580)
- National Institute of Dental and Craniofacial Research (R01DE014386)
- National Center for Research Resources (M01RR000334)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- androgen deficiency, estradiol deficiency, osteoporosis, bone loss, older men, bone mineral density, sex hormone deficiency, hip bone loss, Osteoporotic Fractures in Men Study
- MeSH terms
- Aged, Aged, 80 and over, Cross-Sectional Studies, Estradiol, Hip, Humans, Longitudinal Studies, Male, Osteoporosis, Radioimmunoassay, Testosterone, Bone Density
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