Elevated FSH, lower estradiol levels associated with greater osteoporosis risk among men with type 2 diabetes
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Men with type 2 diabetes are more likely to develop osteoporosis if they have elevated follicle-stimulating hormone, or FSH, whereas elevated estradiol is associated with lower osteoporosis risk, according to findings published in the Journal of Diabetes.
“There is a need to better understand the role of sex hormones in men with type 2 diabetes, which is a group at higher risks of osteoporosis and fractures,” Hongyan Zhao, MD, PhD, of the department of endocrine and metabolic diseases at Ruijin Hospital and Jiaotong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center for Endocrine and Metabolic Diseases in China, and colleagues wrote.
Between 2010 and 2018, Zhao and colleagues evaluated levels of sex hormone-binding globulin, FSH, prolactin, total testosterone, free testosterone and estradiol for 482 men with type 2 diabetes (mean age, 52.2 years) at Rui-jin Hospital. The researchers also evaluated bone mineral density at the lumbar spine, femoral neck and total hip and, based on the WHO Fracture Risk Algorithm (FRAX), determined risk for fractures across 10 years in the cohort.
According to the researchers, there were associations between FSH and lumbar spine BMD, major osteoporotic fractures and hip fractures and associations between estradiol and femoral neck and total hip BMD.
Osteoporosis and osteopenia were more likely to develop among participants with more than 8.1 mIU/mL FSH, which the researchers categorized as high, compared with participants with 8.1 mIU/mL or less (OR = 2.92; 95% CI, 1.66-5.14). Osteoporosis and osteopenia were less likely to develop among participants with 84.4 pmol/L or more of estradiol, which the researchers categorized as high, compared with participants with less than 84.4 pmol/L (OR = 0.37; 95% CI, 0.22-0.6).
“The present study confirms that estradiol is associated with BMDs and serves as a protective factor for osteoporosis/osteopenia in males,” the researchers wrote.
The researchers noted that osteoporosis and osteopenia were 5.05 times more likely for participants with high FSH levels and low estradiol levels vs. those with low FSH levels and high estradiol levels (OR = 5.05; 95% CI, 95% CI, 1.37-18.65).
“Although the biological mechanism of how FSH is involved in diabetic bone and fractures is not clearly understood, in particular among men, our results and others still suggest that measurement of FSH and estradiol could provide a clue to the risk of osteoporosis/osteopenia and future fracture risk in males with type 2 diabetes,” the researchers wrote. – by Phil Neuffer
Disclosures: The authors report no relevant financial disclosures.
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