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Body composition and circulating estradiol are the main bone density predictors in healthy young and middle-aged men

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Abstract

Purpose

Current fracture risk assessment options in men call for improved evaluation strategies. Recent research directed towards non-classic bone mass determinants have often yielded scarce and conflicting results. We aimed at investigating the impact of novel potential bone mass regulators together with classic determinants of bone status in healthy young and middle-aged men.

Methods

Anthropometric measurements, all-site bone mineral density (BMD) and body composition parameters assessed by dual-energy X-ray absorptiometry and also serum concentrations of (1) the adipokines leptin and resistin, (2) vitamin D and parathormone (PTH), (3) sex hormone binding globulin (SHBG), total testosterone and estradiol (free testosterone was also calculated) and (4) C-terminal telopeptide of type I collagen (CTx) were obtained from 30 apparently healthy male volunteers aged 20–65 years enrolled in this cross-sectional study.

Results

Only lean mass (LM) and total estradiol independently predicted BMD in men in multiple regression analysis, together explaining 49% (p ≤ 0.001) of whole-body BMD variance. Hierarchical regression analysis with whole-body BMD as outcome variable demonstrated that the body mass index (BMI) beta coefficient became nonsignificant when LM was added to the model. Adipokines, fat parameters, testosterone (total and free), SHBG, PTH and vitamin D were not independently associated with BMD or CTx.

Conclusions

The present study shows that LM and sex hormones—namely estradiol—are the main determinants of bone mass in young and middle-aged men. The effects of BMI upon BMD seem to be largely mediated by LM. Lifestyle interventions should focus on preserving LM in men for improved bone outcomes.

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Acknowledgements

The authors acknowledge Mr. Valentin Zaharia and Mr. Adrian Aancute for excellent DXA technical work.

Funding

This work was financed through an internal grant (31587/23.12.2015) from the University of Medicine and Pharmacy “Gr. T. Popa” Iasi, Romania.

Author information

Authors and Affiliations

  1. Department of Endocrinology, “St. Spiridon” Hospital, “Grigore T. Popa” University of Medicine and Pharmacy, No. 1 Independentei Blvd, 700111, Iasi, Romania

    S. C. Bilha, D. Branisteanu, C. Buzduga & M. C. Ungureanu

  2. Immunology Department, “St. Spiridon” Hospital, No.1 Independentei Blvd, 700111, Iasi, Romania

    D. Constantinescu, P. Cianga & E. Anisie

  3. Nephrology Department, Dialysis and Renal Transplant Center, “C.I. Parhon” University Hospital, “Grigore T. Popa” University of Medicine and Pharmacy, No. 50 Carol I Blvd, 700503, Iasi, Romania

    A. Covic

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  1. S. C. Bilha
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Corresponding author

Correspondence to D. Branisteanu.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in this research involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Bilha, S.C., Branisteanu, D., Buzduga, C. et al. Body composition and circulating estradiol are the main bone density predictors in healthy young and middle-aged men. J Endocrinol Invest 41, 995–1003 (2018). https://doi.org/10.1007/s40618-018-0826-z

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  • DOI: https://doi.org/10.1007/s40618-018-0826-z

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