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.

Obesity Status and Predictors of Obesity for Military Executive Members of the Korean Army Personnel

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The role of androgens or growth factors in the bone resorption process in recent spinal cord injured patients: a cross-sectional study

“…At 3 months, all the patients with SCI were using manual or electrical wheelchairs. The able-bodied control group comprised 12 age-matched healthy males with a mean age of 2774.2 years (range [22][23][24][25][26][27][28][29][30][31][32][33][34][35].…”

The quantitative ADAM questionnaire: a new tool in quantifying the severity of hypogonadism

“…Some symptoms that were earlier thought to be the effects of aging in males have been found to be more prevalent in patients with hypogonadism. 3 These include changes in bone mineral density, [3][4][5][6] muscle strength, [7][8][9] cognition, 10 body composition, 11,12 and sexual function. [13][14][15] These studies provide evidence of a correlation between decreasing testosterone levels and symptoms, although they fail to give clear evidence for causality.…”