scholarly journals Long-Term Effect of Testosterone Therapy on Bone Mineral Density in Hypogonadal Men

1997 ◽  
Vol 82 (8) ◽  
pp. 2386-2390 ◽  
Author(s):  
Hermann M. Behre ◽  
Sabine Kliesch ◽  
Eckhard Leifke ◽  
Thomas M. Link ◽  
Eberhard Nieschlag
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Quantitative Computed Tomography ◽  
First Year ◽  
Mineral Density ◽  
Normal Range ◽  
Testosterone Therapy ◽  
Testosterone Treatment ◽  
Testosterone Substitution

In both men and women, a decrease in bone mineral density (BMD) is a major symptom of hypogonadism. Although the effects of estrogens on osteoporosis in women are well documented, comparatively little is known about the effects of long term testosterone substitution on BMD in hypogonadal men. Therefore, we studied BMD in 72 hypogonadal patients (37 men with primary and 35 men with secondary hypogonadism) under testosterone substitution therapy that continued for up to 16 yr. Thirty-two of these men were also seen before initiation of therapy. At annual intervals, trabecular BMD of the lumbar spine was measured by quantitative computed tomography, a true volumetric and reproducible method for long term serial BMD measurements. Serum levels of testosterone increased to the normal range in all androgen-treated hypogonadal men. The most significant increase in BMD was seen during the first year of testosterone treatment in previously untreated patients, when BMD increased from 95.2 ± 5.9 to 120.0 ± 6.1 mg/cm3 hydroxyapatite (mean ± se). Long term testosterone treatment maintained BMD in the age-dependent reference range in all 72 hypogonadal men, independent of the type of hypogonadism. Transdermal testosterone patches applied to the scrotum were as effective in normalizing BMD as im testosterone enanthate injections. In summary, testosterone therapy increases BMD in hypogonadal men regardless of age. The greatest increase is seen during the first year of treatment in previously untreated patients with low initial BMD. In hypogonadal men, BMD can be normalized and maintained in the normal range by continuous, long term testosterone substitution.

scholarly journals Long-Term Effects in Bone Mineral Density after Different Bariatric Procedures in Patients with Type 2 Diabetes: Outcomes of a Randomized Clinical Trial

2020 ◽  
Vol 9 (6) ◽  
pp. 1830 ◽  
Author(s):  
Fernando Guerrero-Pérez ◽  
Anna Casajoana ◽  
Carmen Gómez-Vaquero ◽  
Nuria Virgili ◽  
Rafael López-Urdiales ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Bone Mineral ◽  
First Year ◽  
Gastrointestinal Hormone ◽  
Long Term Effects ◽  
Mineral Density ◽  
Greater Curvature

There is scant evidence of the long-term effects of bariatric surgery on bone mineral density (BMD). We compared BMD changes in patients with severe obesity and type 2 diabetes (T2D) 5 years after randomization to metabolic gastric bypass (mRYGB), sleeve gastrectomy (SG) and greater curvature plication (GCP). We studied the influence of first year gastrointestinal hormone changes on final bone outcomes. Forty-five patients, averaging 49.4 (7.8) years old and body mass index (BMI) 39.4 (1.9) kg/m2, were included. BMD at lumbar spine (LS) was lower after mRYGB compared to SG and GCP: 0.89 [0.82;0.94] vs. 1.04 [0.91;1.16] vs. 0.99 [0.89;1.12], p = 0.020. A higher percentage of LS osteopenia was present after mRYGB 78.6% vs. 33.3% vs. 50.0%, respectively. BMD reduction was greater in T2D remitters vs. non-remitters. Weight at fifth year predicted BMD changes at the femoral neck (FN) (adjusted R2: 0.3218; p = 0.002), and type of surgery (mRYGB) and menopause predicted BMD changes at LS (adjusted R2: 0.2507; p < 0.015). In conclusion, mRYGB produces higher deleterious effects on bone at LS compared to SG and GCP in the long-term. Women in menopause undergoing mRYGB are at highest risk of bone deterioration. Gastrointestinal hormone changes after surgery do not play a major role in BMD outcomes.

Effect of Testosterone treatment on bone microarchitecture and bone mineral density in men: a two-year RCT

2021 ◽  
Author(s):  
Mark Ng Tang Fui ◽  
Rudolf Hoermann ◽  
Karen Bracken ◽  
David J Handelsman ◽  
Warrick J Inder ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Bone Microarchitecture ◽  
Quantitative Computed Tomography ◽  
Distal Tibia ◽  
Mineral Density ◽  
Testosterone Undecanoate ◽  
Testosterone Treatment ◽  
Bone Remodeling Markers

Abstract Context Testosterone treatment increases bone mineral density (BMD) in hypogonadal men. Effects on bone microarchitecture, a determinant of fracture risk, are unknown. Objective Determine the effect of testosterone treatment on bone microarchitecture using high resolution-peripheral quantitative computed tomography (HR-pQCT). Design, Setting, Participants Men&gt;50 years were recruited from six Australian centres. Interventions Injectable testosterone undecanoate or placebo over 2 years on the background of a community-based lifestyle program. Main outcomes Primary endpoint was cortical volumetric BMD (vBMD) at the distal tibia, measured using HR-pQCT in 177 men (one centre). Secondary endpoints included other HR-pQCT parameters and bone remodelling markers. Areal BMD (aBMD) was measured by dual energy X-ray absorptiometry (DXA) in 601 men (five centres). Using a linear mixed model for repeated measures, the mean adjusted differences (MAD) [95% CI] at 12 and 24 months between groups are reported as treatment effect. Results Over 24 months, testosterone treatment, compared to placebo, increased tibial cortical vBMD), 9.33mgHA/cm 3[3.96;14.71],p&lt;0.001 or 3.1%[1.2;5.0], radial cortical vBMD, 8.96mgHA/cm 3[3.30;14.62],p=0.005 or 2.9%[1.0;4.9], total tibial vBMD, 4.16mgHA/cm 3[2.14;6.19],p&lt;0.001 or 1.3%[0.6;1.9] and total radial vBMD, 4.42mgHA/cm 3[1.67;7.16],p=0.002 or 1.8%[0.4;2.0]. Testosterone also significantly increased cortical area and thickness at both sites. Effects on trabecular architecture were minor. Testosterone reduced bone remodeling markers CTX, -48.1ng/L[-81.1;-15.1],p&lt;0.001, and P1NP, -6.8μg/L[-10.9;-2.7], p&lt;0.001. Testosterone significantly increased aBMD at the lumbar spine, 0.04 g/cm 2[0.03;0.05],p&lt;0.001, and the total hip, 0.01g/cm 2[0.01;0.02],p&lt;0.001. Conclusions In men&gt;50 years, testosterone treatment for 2 years increased volumetric bone density, predominantly via effects on cortical bone. Implications for fracture risk reduction require further study.

scholarly journals Long-term Bone Loss and Deterioration of Microarchitecture After Gastric Bypass in African American and Latina Women

2020 ◽  
Author(s):  
Alexandra Krez ◽  
Sanchita Agarwal ◽  
Mariana Bucovsky ◽  
Donald J McMahon ◽  
Yizhong Hu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
African American ◽  
Bone Loss ◽  
Bone Mineral ◽  
Quantitative Computed Tomography ◽  
Latina Women ◽  
Mineral Density

Abstract Context The prevalence of obesity is burgeoning among African American and Latina women; however, few studies investigating the skeletal effects of bariatric surgery have focused on these groups. Objective To investigate long-term skeletal changes following Roux-en-Y gastric bypass (RYGB) in African American and Latina women. Design Four-year prospective cohort study. Patients African American and Latina women presenting for RYGB (n = 17, mean age 44, body mass index 44 kg/m2) were followed annually for 4 years postoperatively. Main Outcome Measures Dual-energy x-ray absorptiometry (DXA) measured areal bone mineral density (aBMD) at the spine, hip, and forearm, and body composition. High-resolution peripheral quantitative computed tomography measured volumetric bone mineral density (vBMD) and microarchitecture. Individual trabecula segmentation-based morphological analysis assessed trabecular morphology and connectivity. Results Baseline DXA Z-Scores were normal. Weight decreased ~30% at Year 1, then stabilized. Parathyroid hormone (PTH) increased by 50% and 25-hydroxyvitamin D was stable. By Year 4, aBMD had declined at all sites, most substantially in the hip. There was significant, progressive loss of cortical and trabecular vBMD, deterioration of microarchitecture, and increased cortical porosity at both the radius and tibia over 4 years. There was loss of trabecular plates, loss of axially aligned trabeculae, and decreased trabecular connectivity. Whole bone stiffness and failure load declined. Risk factors for bone loss included greater weight loss, rise in PTH, and older age. Conclusions African American and Latina women had substantial and progressive bone loss, deterioration of microarchitecture, and trabecular morphology following RYGB. Further studies are critical to understand the long-term skeletal consequences of bariatric surgery in this population.

Determinants of bone mineral density in long-term adult survivors of childhood cancer

2013 ◽  
Author(s):  
C Klap B ◽  
L te Winkel M ◽  
den Hoed M ◽  
van Waas M ◽  
J C M M Neggers S ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Childhood Cancer ◽  
Bone Mineral ◽  
Adult Survivors ◽  
Mineral Density ◽  
Survivors Of Childhood Cancer

scholarly journals Nutritional Status in Spanish Adults with Celiac Disease Following a Long-Term Gluten-Free Diet Is Similar to Non-Celiac

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1626
Author(s):  
Catalina Ballestero-Fernández ◽  
Gregorio Varela-Moreiras ◽  
Natalia Úbeda ◽  
Elena Alonso-Aperte
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Celiac Disease ◽  
Vitamin E ◽  
Nutritional Status ◽  
Bone Mineral ◽  
Biochemical Parameters ◽  
Gluten Free ◽  
Mineral Density

The only available treatment for celiac disease is life-long gluten exclusion. We conducted a cross-sectional age- and gender-matched study in 64 celiac adults on a long-term (>1 year) gluten-free diet and 74 non-celiac volunteers from Spain, using dietary, anthropometric, and biochemical parameters, as well as assessing bone mineral density and physical activity. Celiac adults had deficient intake (below 2/3 of the recommended intake) for folates, vitamin E, and iodine and low intake of calcium (below 80% of the recommended intake). Iron intake was also below 2/3 of the recommended intake in celiac women. Vitamin D intake was extremely low, and 34% of celiac patients had moderately deficient plasma levels. According to bone mineral density, celiac women may be more prone to osteopenia and osteoporosis. However, we found a perfectly analogous nutritional status scenario in celiac as compared to healthy volunteers, with the dietary deviations found being similar to those of the Spanish population, i.e., both groups followed a high-lipid, high-protein, and low-carbohydrate diet. Values for biochemical parameters were found within the reference ranges. Celiac disease had no influence on body weight, but body fat in celiac patients tended to be higher. According to our results, vitamin D, calcium, folates, vitamin E, iodine, and iron nutritional status should be specifically assessed and monitored in the celiac population.

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