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Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism.
Abstract
Acquired hypogonadism is being increasingly recognized in adult men. However, the effects of long term testosterone replacement on bone density and body composition are largely unknown. We investigated 36 adult men with acquired hypogonadism (age, 22-69 yr; median, 58 yr), including 29 men with central hypogonadism and 7 men with primary hypogonadism, and 44 age-matched eugonadal controls. Baseline evaluation included body composition analysis by bioimpedance, determination of site-specific adipose area by dual energy quantitative computed tomography scan (QCT) of the lumbar spine, and measurements of spinal bone mineral density (BMD) using dual energy x-ray absortiometry, spinal trabecular BMD with QCT, and radial BMD with single photon absorptiometry. Percent body fat was significantly greater in the hypogonadal men compared to eugonadal men (mean +/- SEM, 26.4 +/- 1.1% vs. 19.2 +/- 0.8%; P < 0.01). The mean trabecular BMD determined by QCT for the hypogonadal men was 115 +/- 6 mg K2HPO4/cc. Spinal BMD was significantly lower than that in eugonadal controls (1.006 +/- 0.024 vs. 1.109 +/- 0.028 g/cm2; P = 0.02, respectively). Radial BMD was similar in both groups. Testosterone enanthate therapy was initiated in 29 hypogonadal men at a dose of 100 mg/week, and the subjects were evaluated at 6-month intervals for 18 months. During testosterone therapy, the percent body fat decreased 14 +/- 4% (P < 0.001). There was a 13 +/- 4% decrease in subcutaneous fat (P < 0.01) and a 7 +/- 2% increase in lean muscle mass (P = 0.01) during testosterone therapy. Spinal BMD and trabecular BMD increased by 5 +/- 1% (P < 0.001) and 14 +/- 3% (P < 0.001), respectively. Radial BMD did not change. Serum bone-specific alkaline phosphatase and urinary deoxypyridinoline excretion, markers of bone formation and resorption, respectively, decreased significantly over the 18 months (P = 0.003 and P = 0.04, respectively). We conclude that testosterone therapy given to adult men with acquired hypogonadism decreases sc fat and increases lean muscle mass. In addition, testosterone therapy reduces bone remodeling and increases trabecular bone density. The beneficial effects of androgen administration on body composition and bone density may provide additional indications for testosterone therapy in hypogonadal men.
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In the citing paper
“Testosterone replacement in men with authentic, pathologically-based hypogonadism reduces fat mass by 10%–15%.7778”
From Lowered testosterone in male obesity: Mechanisms, morbidity and management (2014) · cites this paper as [77]
In the citing paper
“T replacement increases libido, sexual motivation and sexual function (134,135,138-143), mood (144), sense of well being, concentration (135,139,143,145-147), self-reported sense of energy (134,135), muscle mass and strength (132,148,149), and the recovery of anemia related to T deficiency (134).”
From Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [134]
In the citing paper
“Treatment increases BMD (132-135) and improves trabecular structure (136) and bone mechanical properties (137).”
From Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline (2016) · cites this paper as [134]
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Metadata
- Authors
- Katznelson, L., Finkelstein, J. S., Schoenfeld, D. A., Rosenthal, D. I., Anderson, E. J., & Klibanski, A.
- Affiliations
- Massachusetts General Hospital (US)
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 1996-12
- Volume
- 81
- Issue
- 12
- Pages
- 4358-4365
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W1974568933
- Semantic Scholar
- 829db808d1847d263af6c33d3397743284ea9f83
- Cited by
- 791
- References
- 38
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 12 · 2023: 13 · 2022: 16 · 2021: 15 · 2020: 15 · 2019: 14 · 2018: 17 · 2017: 18 · 2016: 22 · 2015: 24 · 2014: 17 · 2013: 29 · 2012: 35
- FWCI
- 19.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5f32dk008738-02)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-08738)
- National Center for Research Resources (RR 01066, M01RR001066)
- 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 › Growth Hormone and Insulin-like Growth Factors
- Keywords
- testosterone replacement therapy, testosterone enanthate, bone mineral density, trabecular bone density, lean body mass, body composition, fat mass, central hypogonadism, hypergonadotropic hypogonadism, bone-specific alkaline phosphatase, urinary deoxypyridinoline, bone turnover markers, men's health, osteoporosis prevention
- MeSH terms
- Adult, Aged, Body Composition, Bone Development, Humans, Hypogonadism, Cholesterol, HDL, Longitudinal Studies, Male, Middle Aged, Parathyroid Hormone, Growth Hormone, Testosterone, Bone Density
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