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Effect of testosterone treatment on the trabecular bone score in older men with low serum testosterone

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Abstract

Summary

The trabecular bone score (TBS) is an indirect measure of vertebral bone microarchitecture. Our objective was to examine the effect of testosterone treatment on TBS. One hundred and ninety-seven hypogonadal men were randomized to testosterone or placebo. After 12 months, there was no difference in the changes in TBS by randomized group.

Introduction

In the Bone Trial of the Testosterone Trials, testosterone treatment increased trabecular volumetric bone mineral density (vBMD) and increased estimated bone strength as determined by finite element analysis. The trabecular bone score (TBS) is an indirect measure of vertebral bone microarchitecture. TBS predicts fracture independent of lumbar spine areal (a) BMD. The objective of this study was to examine the effect of testosterone treatment on TBS compared to its effects on vBMD and aBMD.

Methods

Two hundred and eleven men were enrolled in the Bone Trial of the Testosterone Trials. Of these, 197 men had 2 repeat TBS and vBMD measurements; 105 men were allocated to receive testosterone, and 92 men to placebo for 1 year. TBS, aBMD, and vBMD were assessed at baseline and month 12.

Results

There was no difference in the percent change in TBS by randomized group: 1.6% (95% confidence intervals (CI) 0.2–3.9) in the testosterone group and 1.4% (95% CI −0.2, 3.1) in the placebo group. In contrast, vBMD increased by 6% (95% CI 4.5–7.5) in the testosterone group compared to 0.4% (95% CI −1.65–0.88) in the placebo groups.

Conclusions

TBS is not clinically useful in monitoring the 1-year effect of testosterone treatment on bone structure in older hypogonadal men.

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Funding

National Institutes on Aging, U01 AG030644.

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Authors and Affiliations

  1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 DeSoto Street, A533, Pittsburgh, PA, 15261, USA

    J. A. Cauley

  2. Department of Biostatistics, Epidemiology and Bioinformatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    S. S. Ellenberg

  3. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA

    A. V. Schwartz

  4. Division of Epidemiology and Community Health, Department of Medicine, University of Minnesota, Minneapolis, MN, USA

    K. E. Ensrud

  5. Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA

    K. E. Ensrud

  6. Departments of Mechanical Engineering and Bioengineering, University of California, Berkeley, Berkeley, CA, USA

    T. M. Keaveny

  7. Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    P. J. Snyder

Authors
  1. J. A. Cauley
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  2. S. S. Ellenberg
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  3. A. V. Schwartz
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  4. K. E. Ensrud
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  5. T. M. Keaveny
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  6. P. J. Snyder
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Corresponding author

Correspondence to J. A. Cauley.

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Conflict of interest

JAC, SEE, TMK, KEE, AVS, and PJS report grants from the National Institutes of Health. In addition, PJS reports grants and nonfinancial support from AbbVie during the conduct of the study. TMK reports consulting for Amgen and O.N. Diagnostics and has equity in O.N. Diagnostics.

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Cauley, J.A., Ellenberg, S.S., Schwartz, A.V. et al. Effect of testosterone treatment on the trabecular bone score in older men with low serum testosterone. Osteoporos Int 32, 2371–2375 (2021). https://doi.org/10.1007/s00198-021-06022-1

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  • DOI: https://doi.org/10.1007/s00198-021-06022-1

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