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Sex steroids show little value in predicting osteoporosis risk in older men
Measuring testosterone, estradiol or sex hormone-binding globulin during the routine evaluation of risk for osteoporosis does not provide substantial information about the risk in older men, study data show.
Eric S. Orwoll, MD, from the division of endocrinology, diabetes and clinical nutrition, bone and mineral unit, Oregon Health & Science University School of Medicine, and colleagues evaluated data from the Osteoporotic Fractures in Men study in the United States, Sweden and Hong Kong on 5,487 men (mean age at baseline, 72-75 years) to determine whether measurement of testosterone, estradiol and SHBG are useful in predicting the risk for fracture or rate of bone loss.
At baseline, serum testosterone, estradiol and SHBG levels were measured and incident fractures reported at 4-month intervals.
During a follow-up of approximately 10 years, there were 619 incident major osteoporotic and 266 hip fractures.
Prevalence of low testosterone (< 300 ng/dL) among participants was 7.6% to 21.3%.
Sex steroids and SHBG did not significantly improve fracture risk discrimination or prediction of bone mineral density change. Testosterone, bioavailable testosterone and SHBG did not significantly improve hip fracture reclassification, according to the researchers.
“Measurements of sex-steroid and SHBG levels in community-dwelling older men did not provide clinically useful information for the prediction of the risk of incident fracture or bone loss,” they wrote. “This information is essential for designing clinically useful algorithms for the evaluation of osteoporosis in older men.” – by Amber Cox
Disclosure: Orwoll reports various financial ties with Amgen, Lilly and Merck.