Effect of testosterone treatment on bone remodelling markers and mineral density in obese dieting men in a randomized clinical trial

Fui, Mark Ng Tang; Hoermann, Rudolf; Nolan, Brendan J; Clarke, Michele V; Zajac, Jeffrey D; Grossmann, Mathis

doi:10.1038/s41598-018-27481-3

Cited by 21 publications

(19 citation statements)

References 41 publications

(54 reference statements)

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“…This nonsignificant effect was also observed for lumbar spine BMD (short-term: 7 RCTs [6,17,18,36,42,48,68], 719 participants, MD 0.00 g/cm 2 , 95% CI − 0.02 g/cm 2 to 0.02 g/cm 2 ; long-term: 2 RCTs [23,54], 156 participants, MD 0.04 g/cm 2 , 95% CI − 0.07 g/cm 2 to 0.14 g/cm 2 , Fig. 4), hip BMD (short-term: 5 RCTs [17,18,36,42,48], 651 participants, MD 0.00 g/cm 2 , 95% CI − 0.02 g/cm 2 to 0.03 g/cm 2 ; long-term: 2 RCTs [23,54], 156 participants, MD 0.03 g/cm 2 , 95% CI − 0.01 g/cm 2 to 0.07 g/cm 2 , Fig. 5) and femur neck BMD (short-term: 3 RCT s [6,18,68], 274 participants, MD 0.00 g/cm 2 , 95% CI − 0.02 g/cm 2 to 0.02 g/cm 2 , Fig.…”

Section: Bmdmentioning

confidence: 69%

“…Ten RCTs with 12 references [11,17,36,40,41,49,54,59,66,67,69,70] reported this outcome. The results showed no significant difference in the risk of cardiovascular events between the placebo and testosterone supplementation groups (1374 participants, RR 1.28, 95% CI 0.62 to 2.64).…”

Section: Incidence Of Cardiovascular Eventmentioning

confidence: 96%

“…Ten RCTs [5,6,17,18,23,36,42,48,54,68] reported this outcome. The results showed, when compared with placebo, testosterone supplementation did not increase total BMD in both the short-term (less than 2 years of treatment) (8 RCTs, 1081 participants, MD − 0.01 g/cm 2 , 95% CI − 0.02 g/cm 2 to 0.01 g/cm 2 , low quality of evidence) and the long-term (more than 2 years of treatment) (2 RCTs, 156 participants, MD 0.04 g/cm 2 , 95% CI − 0.07 g/cm 2 to 0.14 g/cm 2 , very low quality of evidence) ( Fig.…”

Section: Bmdmentioning

confidence: 97%

“…Three reviews [14][15][16] evaluated the efficacy of testosterone therapy in males with late-onset hypogonadism (LOH) and found that testosterone increased BMD. However, these reviews were either out of date or they omitted relevant studies; several RCTs reported no effect of testosterone on BMD after these reviews [17,18] were published. Given these conflicting results, an update of the evidence regarding the impact of testosterone supplementation on BMD is required.…”

Section: Introductionmentioning

confidence: 99%

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The effects of testosterone on bone health in males with testosterone deficiency: a systematic review and meta-analysis

Zhang

Kang

2020

BMC Endocr Disord

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Background: Testosterone deficiency (TD) may induce a series of clinical symptoms. Studies have shown that testosterone supplementation may prevent these unfavourable symptoms and improve patients' quality of life. Given the conflicting findings across studies, this systematic review aims to evaluate the effects and risks associated with testosterone supplementation in middle-aged or aging males with TD. Methods: Electronic databases (MEDLINE, EMBASE, PubMed, and Cochrane. Library were searched to December 2019. The risk of bias of individual included studies and the quality of the aggregate evidence were assessed using the GRADE approach. Our primary outcome was bone mineral density (BMD). Meta-analyses were performed. This systematic review was reported according to the PRISMA statement. Results: A total of 52 randomized controlled trials (RCTs) were included. When compared with placebo, testosterone supplementation did not increase total BMD (short-term: 1081 participants, MD − 0.01 g/cm 2 , 95% CI − 0.02 g/cm 2 to 0.01 g/cm 2 ; long-term: 156 participants, MD 0.04 g/cm 2 , 95% CI − 0.07 g/cm 2 to 0.14 g/cm 2), lumbar spine, hip, or femur neck BMD. Furthermore, testosterone supplementation did not decrease the risk of falling or fracture. Lastly, it was found that testosterone supplementation did not increase the risk of cardiovascular events (1374 participants, RR 1.28, 95% CI 0.62 to 2.64), all-cause mortality (729 participants, RR 0.55, 95% CI 0.29 to 1.04), or prostatic events. However, testosterone supplementation may improve sexual function and quality of life (1328 participants, MD-1.32, 95% CI − 2.11 to − 0.52). Conclusions: The effect of testosterone supplementation on BMD and the risk of falls or fracture remains inconclusive. However, supplementation may benefit patients in the areas of sexual function and quality of life without increasing the risk of cardiovascular events, all-cause mortality, or prostatic events. RCTs with a longer follow-up period are still required. Trial registration: We registered our protocol in PROSPERO (CRD42018109738).

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Section: Bmdmentioning

confidence: 69%

Section: Incidence Of Cardiovascular Eventmentioning

confidence: 96%

Section: Bmdmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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The effects of testosterone on bone health in males with testosterone deficiency: a systematic review and meta-analysis

Zhang

Kang

2020

BMC Endocr Disord

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“…10,[31][32][33] Moreover, in older men, T replacement therapy has been proven to have a limited effect in helping increase BMD at various bone sites compared with the control group. [34][35][36] Actually, concentrations of total E2 were suggested to be more strongly associated with bone mass and bone loss than T or FT in both young and aging men. 7,37,38 It is worth mentioning that although genetic evidence showed racial differences in E2 levels and the E2/T ratio, 39 E2 was still associated with BMD in men, [39][40][41] and the associations between steroid hormones and BMD were even consistent across racial and ethnic groups.…”

Section: Discussionmentioning

confidence: 99%

Follicle‐stimulating hormone and estradiol are associated with bone mineral density and risk of fractures in men with type 2 diabetes mellitus

Jing

Wang

et al. 2019

Journal of Diabetes

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Background: Type 2 diabetes mellitus (T2DM) is associated with a higher fracture risk. Sex hormones are important for maintaining skeletal health. It is not clear which sex hormone(s) contribute(s) to bone mineral density (BMD) and fracture risk in males with T2DM. This study investigated the relationships of these parameters in males with T2DM. Methods: This study involved 482 men with T2DM. BMDs at the lumbar spine (L2-4), femoral neck (FN), and total hip (TH) were measured by dualenergy X-ray absorptiometry (DXA). The 10-year probability of fractures was assessed using the modified Fracture Risk Algorithm (FRAX) tool. Serum levels of sex hormones were measured. Results: Follicle-stimulating hormone (FSH) and estradiol (E2) were associated with BMDs at L2-4 (FSH, β = −.162, P < .05; E2, β = .176, P < .001), and E2 was associated with BMD at FN (β = .137, P < .05) and TH (β = .140, P < .05). FSH was associated with major osteoporotic fractures (β = .288, P < .001) and hip fractures (β = .235, P < .001). Higher FSH was a risk factor for osteoporosis/osteopenia (odds ratios [OR] = 2.92, 95% CI = 1.66-5.14, P < .001), whereas higher E2 was a protective factor (OR = 0.37, 95% CI = 0.22-0.60, P < .001). Patients in the higher tertile of FSH and lower tertile of E2 had an increased risk of osteoporosis/osteopenia (OR = 5.05, 95% CI = 1.37-18.65, P < .05).Conclusions: For males with T2DM, FSH and E2 are significantly associated with BMD, osteoporosis/osteopenia, and fracture risk. Highlights• Follicle-stimulating hormone (FSH) and estradiol (E2) were significantly associated with bone mineral density in male with type 2 diabetes mellitus (T2DM). • FSH was strongly associated with fracture risk measured by the modified Fracture Risk Algorithm (FRAX) tool in males with T2DM.

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Testosterone replacement in men with sexual dysfunction

Lee,

Hwang,

et al. 2024

Cochrane Database of Systematic Reviews

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Effect of testosterone treatment on bone remodelling markers and mineral density in obese dieting men in a randomized clinical trial

Cited by 21 publications

References 41 publications

The effects of testosterone on bone health in males with testosterone deficiency: a systematic review and meta-analysis

The effects of testosterone on bone health in males with testosterone deficiency: a systematic review and meta-analysis

Follicle‐stimulating hormone and estradiol are associated with bone mineral density and risk of fractures in men with type 2 diabetes mellitus

Testosterone replacement in men with sexual dysfunction

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