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Effects of long-acting testosterone undecanoate on bone mineral density in middle-aged men with late-onset hypogonadism and metabolic syndrome: results from a 36 months controlled study
Open accessAbstract
We evaluated the effects of long-term testosterone replacement therapy (TRT) on the bone mineral density (BMD) in obese patients with metabolic syndrome (MS) and late-onset hypogonadism (LOH). Sixty men (mean age 57 ± 10) with low serum testosterone (T < 320 ng/dL) and MS regardless the presence of osteoporosis were enrolled. Forty men received intramuscular T-undecanoate (TU) four times/year for 36 months and 20 age-matched hypogonadal men with MS in whom T treatment was contraindicated were used as controls. Hormonal, biochemical markers, vertebral and femoral BMD by dual-energy x-ray absorptiometry were measured. At baseline, overall patients had mild osteopenia (lumbar BMD= 0.891 ± 0.097 g/cm(2); femoral BMD= 0.847 ± 0.117 g/cm(2)). TU induced a significant improvement of bone mass after 36 months (lumbar BMD=1.053 ± 0.145 g/cm(2); p < 0.002; femoral BMD=0.989 ± 0.109; p < 0.003 g/cm(2)) with a 5%/year increase and a significant reduction in hs-CRP without changes in body mass index. A direct relationship between serum T and BMD increments at the lumbar (r(2) = 0.66, p < 0.0001) and femoral (r(2) =0.52, p < 0.0001) sites was demonstrated. Study adherence was 50% without serious side effects. Long-term TRT in middle-aged men with LOH and MS determines a significant increase in both vertebral and femoral BMD related to increased serum T levels, probably independently from estradiol modifications.
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“Inversely, a 3-year prospective, controlled trial of T supplementation in hypogonadal men demonstrated a 5% per year improvement in BMD.”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [127]
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“This is evidenced by the significant variation on bone mineral density among the reported therapies.126, 127, 135”
From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [127]
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Metadata
- Authors
- Aversa, A., Bruzziches, R., Francomano, D., Greco, E. A., Fornari, R., Luigi, L. D., Lenzi, A., & Migliaccio, S.
- Affiliations
- Sapienza University of Rome (IT)
- Foro Italico University of Rome (IT)
- Venue
- The Aging Male
- Publisher
- Informa UK Limited
- Published
- 2012-03-23
- Volume
- 15
- Issue
- 2
- Pages
- 96-102
- ISSN
- 1368-5538 (ISSN-L)
- 1473-0790
- OpenAlex
- W2145291570
- Cited by
- 108
- References
- 52
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 10 · 2022: 2 · 2021: 8 · 2020: 6 · 2019: 7 · 2018: 9 · 2017: 7 · 2016: 7 · 2015: 11 · 2014: 14 · 2013: 13 · 2012: 4
- FWCI
- 10.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Aging Male (publishedVersion)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- 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
- testosterone undecanoate, testosterone replacement therapy, bone mineral density, andropause, metabolic syndrome, obesity, osteopenia, middle-aged men, serum testosterone, C-reactive protein, estradiol, medication adherence
- MeSH terms
- Aged, Androgens, Femur, Humans, Hypogonadism, Male, Middle Aged, Obesity, Spine, Testosterone, Bone Density, Metabolic Syndrome
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