Elsevier

Bone

Volume 18, Issue 2, February 1996, Pages 171-177
Bone

Original article
Androgen supplementation in eugonadal men with osteoporosis—effects of 6 months of treatment on bone mineral density and cardiovascular risk factors

https://doi.org/10.1016/8756-3282(95)00441-6Get rights and content

Abstract

This open, prospective therapeutic trial studied the effects of regular moderate androgen supplementation on bone mineral density in eugonadal men with established osteoporosis, and collected data on the safety of androgen therapy used in this setting. 23 men, aged 34–73 years, with vertebral crush fractures and back pain, in whom secondary causes of osteoporosis had been excluded, were treated with fortnightly intramuscular injections of 250 mg testosterone esters (Sustanon 250®) for 6 months. Blood pressure was recorded monthly; fasting lipids, glucose, haematocrit, plasma viscosity, and testosterone levels were measured every 3 months. Psychological effects were assessed using the Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ), together with questioning on libido changes. Principal outcomes measured were changes in bone mineral density at the hip and spine by dual-energy X-ray absorptiometry (DEXA) over the treatment period. 21 men completed the study period. Mean bone mineral density at the lumbar spine increased from 0.799 g/cm2 to 0.839 g/cm2 during treatment (p < 0.001), a rise of 5% in 6 months. Bone mineral density at the hip did not change. There were significant, favorable changes in diastolic blood pressure (−4.7 mmHg, p < 0.01), serum triglyceride levels (−0.405 mmol/L, p < 0.01), and total cholesterol (−0.27 mmol/L, p < 0.05). Adverse changes included a fall in HDL cholesterol (−0.087 mmol/L, p < 0.05) and a rise in plasma viscosity which was significant at 3 months but not at 6 months. The expected rises in hematocrit (0.434 to 0.456) and FAI (0.504 to 0.887) occurred. We conclude that testosterone supplementation significantly increased bone mineral density in this heterogeneous group of men with idiopathic primary osteoporosis, without an overall adverse effect on cardiovascular risk factors. This treatment warrants further evaluation in a randomized, controlled trial.

References (46)

  • D.G Altman

    Practical statistics for medical research

  • C.J. Bagatell et al.

    Physiological levels of estradiol stimulate plasma high density lipoprotein 2 cholesterol levels in normal men

    J Clin Endocrinol Metab

    (1994)
  • S.P. Baillie et al.

    Pathogenesis of vertebral crush fractures in men

    Age Ageing

    (1992)
  • D.M. Black et al.

    Axial and appendicular bone density predict fractures in older women

    J Bone Miner Res

    (1992)
  • J.M. Bland et al.

    Multiple significance tests: the Bonferroni method

    Br Med J

    (1995)
  • C. Cooper

    Epidemiology and public health impact of osteoporosis

  • P. Delmas et al.

    L'osteoporose au cours du syndrome de klinefelters

    Nou Presse Med

    (1981)
  • T. Diamond et al.

    Effects of testosterone and venesection on spinal and peripheral bone mineral in six hypogonadal men with haemochromatosis

    J Bone Miner Res

    (1991)
  • E. Farish et al.

    Lipoprotein(a) concentrations in postmenopausal women taking norethisterone

    Br Med J

    (1991)
  • J.S. Finklestein et al.

    Increases in bone density during treatment of men with idiopathic hypogonadotrophic hypogonadism

    J Clin Endocrinol Metab

    (1989)
  • C. Foresta et al.

    Lower calcitonin levels in young hypogonada men with osteoporosis

    Hormone Metab Res

    (1983)
  • D.S. Freedman et al.

    Relation of serum testosterone levels to high density lipoprotein cholesterol and other characteristics in men

    Arterioscler Throm

    (1991)
  • K.E. Freidl et al.

    The administration of pharmacological doses of testosterone or 19-nortestosterone to normal men is not associated with increased insulin secretion or impaired glucose tolerance

    J Clin Endocrinol Metab

    (1989)
  • Cited by (115)

    • Interaction between testosterone and obesity on hypertension: A population-based cross-sectional study

      2021, Atherosclerosis
      Citation Excerpt :

      Thus, high levels of testosterone may reduce the risk of hypertension by inhibiting inflammatory cytokine expression and function. Moreover, several clinical studies have reported that testosterone replacement therapy is beneficial for BP and hypertension [41,42]. In contrast, a recent study conducted in Australia showed a small increase in 24-h SBP in men after 12 weeks of testosterone treatment [43].

    • Lifestyle modification-induced increase in serum testosterone and SHBG decreases arterial stiffness in overweight and obese men

      2014, Artery Research
      Citation Excerpt :

      Moreover, the changes in mean blood pressure were negatively associated with changes in non MAP-adjusted cfPWV (β = 0.682, P < 0.05) and changes in serum testosterone levels (β = −0.646, P < 0.05) due to lifestyle modifications on stepwise multivariable linear regression analysis. Furthermore, testosterone replacement therapy has been shown to have an anti-hypertensive effect in obese men.27–29 Thus, we suggest that the increased serum testosterone levels induces the lowering of the mean blood pressure, thereby contributing to the decrease in non MBP-adjusted cfPWV.

    • Bone Health and Associated Metabolic Complications in Neuromuscular Diseases

      2012, Physical Medicine and Rehabilitation Clinics of North America
    • Testosterone Deficiency and Risk Factors in the Metabolic Syndrome: Implications for Erectile Dysfunction

      2011, Urologic Clinics of North America
      Citation Excerpt :

      The investigators noted that the most significant reductions occurred between 6 to 9 months. In addition, Anderson and colleagues33 reported a significant favorable change in diastolic blood pressure in men treated for 6 months with T-replacement therapy. Given the fact that the relationship between hypertension and TD is complex and poorly investigated, the limited data available still suggest that T-replacement therapy tends to normalize blood pressure; however, this remains to be investigated.

    • Androgens and the Skeleton - Humans

      2010, Osteoporosis in Men
    View all citing articles on Scopus
    View full text