Men over age 60 who have low blood testosterone levels may be at a higher risk for fractures, according to a report in the January 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
One-third of all osteoporotic fractures caused by porous bones occur in men, according to background information in the article. Men with a previous osteoporotic fracture have three to four times the risk of having another fracture than a woman of the same age with a fracture. “Preventing the first such fracture may have major public health implications,” the authors note. “Thus, understanding the determinants of fracture risk in men may reduce the burden of disease through facilitating better prevention strategies.”
Christian Meier, M.D., of the University of Sydney, Concord, New South Wales, Australia, and colleagues observed 609 men (average age 72.6) between January 1989 and December 2005. The men’s bone mineral density and lifestyle factors were recorded at the beginning of the study. Serum testosterone and estradiol (an estrogen) levels were measured and the occurrence of a low-trauma fracture (associated with a fall from standing height or less) was determined during follow-up.
Low-trauma fractures occurred in 113 men during follow-up with the risk of fracture significantly higher in those with low testosterone levels. “Twenty-five men experienced multiple incident fractures,” the authors note. “A total of 149 incident fractures were reported, including 55 vertebral, 27 hip, 28 rib, six wrist and 16 upper and 17 lower extremity fractures.”
“After adjustment for sex hormone−binding globulin (a blood protein), serum testosterone and serum estradiol levels were associated with overall fracture risk,” according to the authors. “After further adjustment for major risk factors of fractures (age, weight or bone mineral density, fracture history, smoking status, calcium intake and sex hormone−binding globulin), lower testosterone was still associated with increased risk of fracture, particularly with hip and non-vertebral fractures.”
The problem with this sort of study is that it doesn't prove the direction of cause and effect. Does poorer health contribute to both lower testosterone and greater risk of bone fracture? Would supplemental testosterone reduce risk fracture? If it did then would it not increase the risk of other health problems? Hard to say. What we really need: rejuvenating cell therapies and gene therapies that will work far better than the most optimistic benefit we could hope to derive from hormone therapy.
|Share |||Randall Parker, 2008 January 23 09:09 PM Aging Studies|