Osteoporosis International

, Volume 21, Issue 8, pp 1331–1339 | Cite as

Gonadal sex steroid status and bone health in middle-aged and elderly European men

  • D. VanderschuerenEmail author
  • S. R. Pye
  • K. Venken
  • H. Borghs
  • J. Gaytant
  • I. T. Huhtaniemi
  • J. E. Adams
  • K. A. Ward
  • G. Bartfai
  • F. F. Casanueva
  • J. D. Finn
  • G. Forti
  • A. Giwercman
  • T. S. Han
  • K. Kula
  • F. Labrie
  • M. E. J. Lean
  • N. Pendleton
  • M. Punab
  • A. J. Silman
  • F. C. W. Wu
  • T. W. O’Neill
  • S. Boonen
  • The EMAS Study Group
Original Article



The influence of sex steroids on calcaneal quantitative ultrasound (QUS) parameters was assessed in a population sample of middle-aged and elderly European men. Higher free and total E2 though not testosterone, were independently associated with higher QUS parameters.


The aim of this study was to investigate the association between QUS parameters and sex steroids in middle-aged and elderly European men.


Three thousand one hundred forty-one men aged between 40 and 79 years were recruited from eight European centres for participation in a study of male ageing: the European Male Ageing Study. Subjects were invited by letter to attend for an interviewer-administered questionnaire, blood sample and QUS of the calcaneus (Hologic-SAHARA). Blood was assessed for sex steroids including oestradiol (E2), testosterone (T), free and bio-available E2 and T and sex hormone binding globulin (SHBG).


Serum total T was not associated with any of the QUS parameters. Free T and both free and total E2 were positively related to all QUS readings, while SHBG concentrations were negatively associated. These relationships were observed in both older and younger (<60 years) men. In a multivariate model, after adjustment for age, centre, height, weight, physical activity levels and smoking, free E2 and SHBG, though not free T, remained independently associated with the QUS parameters. After further adjustment for IGF-1, however, the association with SHBG became non-significant.


Higher free and total E2 are associated with bone health not only among the elderly but also middle-aged European men.


Epidemiology Oestradiol Sex steroids SHBG Testosterone Ultrasound 



The European Male Ageing Study is funded by the Commission of the European Communities Fifth Framework Programme “Quality of Life and Management of Living Resources” Grant QLK6-CT-2001-00258 and supported by funding from the UK Arthritis Research Campaign. For additional information regarding EMAS, contact Frederick Wu, MD; Dept of Endocrinology, Manchester Royal Infirmary, UK. The authors wish to thank the men who participated in the eight countries, the research/nursing staff in the eight centres: C Pott, Manchester, E Wouters, Leuven, M Nilsson, Malmö, M del Mar Fernandez, Santiago de Compostela, M Jedrzejowska, Lodz, H-M Tabo, Tartu, A Heredi, Szeged for their data collection and C Moseley, Manchester for data entry and project coordination. Dr. Vanderschueren and Dr. Boonen are senior clinical investigators of the Fund for Scientific Research-Flanders, Belgium (F.W.O.-Vlaanderen). Dr. Boonen is holder of the Leuven University Chair in Metabolic Bone Diseases. K Venken is a postdoctoral fellow of the Fund for Scientific Research-Flanders (F.W.O.-Vlaanderen).

Conflicts of interest



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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009

Authors and Affiliations

  • D. Vanderschueren
    • 1
    Email author
  • S. R. Pye
    • 2
  • K. Venken
    • 1
  • H. Borghs
    • 3
  • J. Gaytant
    • 1
  • I. T. Huhtaniemi
    • 4
  • J. E. Adams
    • 5
  • K. A. Ward
    • 5
    • 6
  • G. Bartfai
    • 7
  • F. F. Casanueva
    • 8
  • J. D. Finn
    • 2
  • G. Forti
    • 9
  • A. Giwercman
    • 10
  • T. S. Han
    • 11
  • K. Kula
    • 12
  • F. Labrie
    • 13
  • M. E. J. Lean
    • 11
  • N. Pendleton
    • 14
  • M. Punab
    • 15
  • A. J. Silman
    • 2
  • F. C. W. Wu
    • 16
  • T. W. O’Neill
    • 2
  • S. Boonen
    • 3
  • The EMAS Study Group
  1. 1.Department of Andrology and EndocrinologyKatholieke Universiteit LeuvenLeuvenBelgium
  2. 2.ARC Epidemiology UnitThe University of Manchester, Manchester Academic Health Science CentreManchesterUK
  3. 3.Leuven University Division of Geriatric Medicine and Centre for Metabolic Bone DiseasesKatholieke Universiteit LeuvenLeuvenBelgium
  4. 4.Department of Reproductive BiologyImperial College LondonLondonUK
  5. 5.Clinical Radiology, Imaging Science and Biomedical EngineeringThe University of Manchester, Manchester Academic Health Science CentreManchesterUK
  6. 6.MRC Human Nutrition ResearchCambridgeUK
  7. 7.Department of Obstetrics, Gynaecology and AndrologyAlbert Szent-Gyorgy Medical UniversitySzegedHungary
  8. 8.Department of MedicineSantiago de Compostela UniversitySantiago de CompostelaSpain
  9. 9.Andrology Unit, Department of Clinical PhysiopathologyUniversity of FlorenceFlorenceItaly
  10. 10.Scanian Andrology Centre, Department of UrologyMalmö University Hospital, University of LundMalmöSweden
  11. 11.Department of EndocrinologyRoyal Free and University College Hospital Medical School, Royal Free HospitalHampsteadLondon
  12. 12.Department of Andrology and Reproductive EndocrinologyMedical University of LodzLodzPoland
  13. 13.Laboratory of Molecular Endocrinology and Oncology, Le Centre hospitalier de l’Universite LavalLaval UniversityQuebecCanada
  14. 14.Clinical GerontologyThe University of Manchester, Manchester Academic Health Science Centre, Hope HospitalSalfordUK
  15. 15.Andrology UnitUnited Laboratories of Tartu University ClinicsTartuEstonia
  16. 16.Department of EndocrinologyThe University of Manchester, Manchester Academic Health Science Centre, Manchester Royal InfirmaryManchesterUK

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