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Bone mineral density and bone markers in hypogonadotropic and hypergonadotropic hypogonadal men after prolonged testosterone treatment

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Abstract

After prolonged treatment (76.4±10 and 70.1±12.3 months, respectively) (mean± SE) with testosterone enanthate (250 mg im every 3 weeks), bone mineral density (BMD) and bone metabolism were evaluated in 12 patients (aged 29.3±1.4 yr) affected by idiopathic hypogonadotropic hypogonadism (IHH), in 8 patients (29.6±2.6 yr) affected by Klinefelter’s syndrome (KS), and in 10 healthy men (30.6±1.7 yr) matched according to age and BMI. Spinal BMD in IHH was significantly lower than in controls (0.804±0.04 vs 1.080±0.01 g/cm2; p<0.001), while there was no difference in neck BMD (0.850±0.01 vs 0.948±0.02 g/cm2). Neither spinal (0.978±0.05 g/cm2) nor neck (0.892±0.03 g/cm2) BMD in KS were significantly different from controls. Six IHH and one KS subjects were osteoporotic, while 6 IHH and 2 KS subjects were osteopenic. A significant inverse correlation was found between spinal BMD and age at the treatment onset in IHH (r=−0.726, p=0.007). In IHH there were significant increases in bone formation (alkaline phosphatase=318.3±33.9 vs 205.4±20.0 IU/l; osteocalcin=13.44±1.44 vs 8.57±0.94 ng/ml; p<0.05) and in bone resorption (urinary cross-linked N-telopeptides of type I collagen= 149.1± 32.3 vs 47.07±8.4 nmol bone collagen equivalents/mmol creatinine; p<0.05) compared to controls, while such differences were not present in KS. Our results outline the importance of BMD evaluation in all hypogonadal males. Nevertheless, bone loss is a minor characteristic of KS, while it is a distinctive feature of IHH. Therefore, early diagnosis and age-related replacement therapy coupled with a specific treatment for osteoporosis could be useful in preventing future severe bone loss and associated skeletal morbidity.

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Authors and Affiliations

  1. Department of Molecular and Clinical Endocrinology and Oncology, University “Federico II”, Naples, Italy

    Michele De Rosa, L. Paesano, V. Nuzzo, S. Zarrilli & G. Lupoli

  2. Rheumatologic Unit, School of Medicine, University “Federico II”, Naples, Italy

    A. Del Puente & P. Oriente

Authors
  1. Michele De Rosa
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  2. L. Paesano
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  3. V. Nuzzo
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  4. S. Zarrilli
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  5. A. Del Puente
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  6. P. Oriente
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  7. G. Lupoli
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Correspondence to Michele De Rosa.

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De Rosa, M., Paesano, L., Nuzzo, V. et al. Bone mineral density and bone markers in hypogonadotropic and hypergonadotropic hypogonadal men after prolonged testosterone treatment. J Endocrinol Invest 24, 246–252 (2001). https://doi.org/10.1007/BF03343854

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