Journal of Clinical Endocrinology & Metabolism, Vol 69, 523-527, Copyright © 1989 by Endocrine Society

ARTICLES

Castrated men exhibit bone loss: effect of calcitonin treatment on biochemical indices of bone remodeling

JJ Stepan, M Lachman, J Zverina, V Pacovsky and DJ Baylink
Department of Medicine 3, Charles University Faculty of Medicine, Prague, Czechoslovakia.

To test the hypothesis that the reduction in gonadal function can lead to bone mass loss, a group of 12 men who had undergone bilateral orchidectomy at the age of 28.2 +/- 6.8 yr was evaluated. A progressive loss of the lumbar bone density was observed as a function of time after orchidectomy. Both the biochemical indices of bone resorption (urinary hydroxyproline/creatinine ratio and plasma tartrate-resistant acid phosphatase) and bone formation (serum osteocalcin and bone isoenzyme of alkaline phosphatase) were significantly increased in the patients compared with healthy controls. A positive correlation was found between urinary hydroxyproline excretion and percent change in spinal bone mineral density per yr. Because of this increase in the biochemically indicated bone resorption, nine of the patients were studied again after 1-3 yr and were thereafter treated with intranasal calcitonin. Urinary hydroxyproline excretion normalized after 3 months of treatment, and a significant decrease, but not to normal levels, was also observed in the mean values for the other biochemical indices of bone remodeling. Thus, testosterone deficiency, like estrogen deficiency, is associated with accelerated bone loss. The increase in osteoresorption was partially corrected by calcitonin treatment.

This article has been cited by other articles:

				C. M. Francucci, C. Gatti, A. Camilletti, P. Fiscaletti, R. Caudarella, and M. Boscaro Hypogonadism and Reduced Bone Mineral Density in Heterozygous H63D Mutation in the HFE Gene: An Unusual Presentation of Hereditary Hemochromatosis J Androl, January 1, 2007; 28(1): 21 - 26. [Full Text] [PDF]

				N. A. Sims, K. Brennan, J. Spaliviero, D. J. Handelsman, and M. J. Seibel Perinatal testosterone surge is required for normal adult bone size but not for normal bone remodeling Am J Physiol Endocrinol Metab, March 1, 2006; 290(3): E456 - E462. [Abstract] [Full Text] [PDF]

				V Rochira, A Balestrieri, B Madeo, L Zirilli, A R M Granata, and C Carani Osteoporosis and male age-related hypogonadism: role of sex steroids on bone (patho)physiology Eur. J. Endocrinol., February 1, 2006; 154(2): 175 - 185. [Abstract] [Full Text] [PDF]

				J. M. Kaufman and A. Vermeulen The Decline of Androgen Levels in Elderly Men and Its Clinical and Therapeutic Implications Endocr. Rev., October 1, 2005; 26(6): 833 - 876. [Abstract] [Full Text] [PDF]

				A. Aminorroaya, S. Kelleher, A. J Conway, L. P Ly, and D. J Handelsman Adequacy of androgen replacement influences bone density response to testosterone in androgen-deficient men Eur. J. Endocrinol., June 1, 2005; 152(6): 881 - 886. [Abstract] [Full Text] [PDF]

				L. Gennari, R. Nuti, and J. P. Bilezikian Aromatase Activity and Bone Homeostasis in Men J. Clin. Endocrinol. Metab., December 1, 2004; 89(12): 5898 - 5907. [Abstract] [Full Text] [PDF]

				D. Vanderschueren, L. Vandenput, S. Boonen, M. K. Lindberg, R. Bouillon, and C. Ohlsson Androgens and Bone Endocr. Rev., June 1, 2004; 25(3): 389 - 425. [Abstract] [Full Text] [PDF]

				M. Benito, B. Gomberg, F. W. Wehrli, R. H. Weening, B. Zemel, A. C. Wright, H. K. Song, A. Cucchiara, and P. J. Snyder Deterioration of Trabecular Architecture in Hypogonadal Men J. Clin. Endocrinol. Metab., April 1, 2003; 88(4): 1497 - 1502. [Abstract] [Full Text] [PDF]

				S. Issa, D. Schnabel, M. Feix, L. Wolf, H.-E. Schaefer, D. W. Russell, and H.-U. Schweikert Human Osteoblast-Like Cells Express Predominantly Steroid 5{alpha}-Reductase Type 1 J. Clin. Endocrinol. Metab., December 1, 2002; 87(12): 5401 - 5407. [Abstract] [Full Text] [PDF]

				U. M. Liegibel, U. Sommer, P. Tomakidi, U. Hilscher, L. van den Heuvel, R. Pirzer, J. Hillmeier, P. Nawroth, and C. Kasperk Concerted Action of Androgens and Mechanical Strain Shifts Bone Metabolism from High Turnover into an Osteoanabolic Mode J. Exp. Med., November 18, 2002; 196(10): 1387 - 1392. [Abstract] [Full Text] [PDF]

				T. Notomi, Y. Okazaki, N. Okimoto, Y. Tanaka, T. Nakamura, and M. Suzuki Effects of tower climbing exercise on bone mass, strength, and turnover in orchidectomized growing rats J Appl Physiol, September 1, 2002; 93(3): 1152 - 1158. [Abstract] [Full Text] [PDF]

				S P Tuck and R M Francis Osteoporosis Postgrad. Med. J., September 1, 2002; 78(923): 526 - 532. [Abstract] [Full Text] [PDF]

				D. Mittan, S. Lee, E. Miller, R. C. Perez, J. W. Basler, and J. M. Bruder Bone Loss following Hypogonadism in Men with Prostate Cancer Treated with GnRH Analogs J. Clin. Endocrinol. Metab., August 1, 2002; 87(8): 3656 - 3661. [Abstract] [Full Text] [PDF]

				B. L. Riggs, S. Khosla, and L. J. Melton III Sex Steroids and the Construction and Conservation of the Adult Skeleton Endocr. Rev., June 1, 2002; 23(3): 279 - 302. [Abstract] [Full Text] [PDF]

				K. K. Miller, B. M. K. Biller, J. Hier, E. Arena, and A. Klibanski Androgens and Bone Density in Women with Hypopituitarism J. Clin. Endocrinol. Metab., June 1, 2002; 87(6): 2770 - 2776. [Abstract] [Full Text] [PDF]

				F. Scopacasa, J.M. Wishart, A.G. Need, M. Horowitz, H.A. Morris, and B.E.C. Nordin Bone Density and Bone-Related Biochemical Variables in Normal Men: A Longitudinal Study J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2002; 57(6): M385 - 391. [Abstract] [Full Text]

				A. M. Matsumoto Andropause: Clinical Implications of the Decline in Serum Testosterone Levels With Aging in Men J. Gerontol. A Biol. Sci. Med. Sci., February 1, 2002; 57(2): M76 - 99. [Full Text]

				Y. Zhang, S. Seshadri, R. C. Ellison, T. Heeren, and D. T. Felson Bone Mineral Density and Verbal Memory Impairment: Third National Health and Nutrition Examination Survey Am. J. Epidemiol., November 1, 2001; 154(9): 795 - 802. [Abstract] [Full Text] [PDF]

				D. M. Huber, A. C. Bendixen, P. Pathrose, S. Srivastava, K. M. Dienger, N. K. Shevde, and J. W. Pike Androgens Suppress Osteoclast Formation Induced by RANKL and Macrophage-Colony Stimulating Factor Endocrinology, September 1, 2001; 142(9): 3800 - 3808. [Abstract] [Full Text] [PDF]

				P. J. Snyder Effects of Age on Testicular Function and Consequences of Testosterone Treatment J. Clin. Endocrinol. Metab., June 1, 2001; 86(6): 2369 - 2372. [Full Text] [PDF]

				K. K. Miller Androgen Deficiency in Women J. Clin. Endocrinol. Metab., June 1, 2001; 86(6): 2395 - 2401. [Abstract] [Full Text] [PDF]

				J. E. Compston Sex Steroids and Bone Physiol Rev, January 1, 2001; 81(1): 419 - 447. [Abstract] [Full Text] [PDF]

				S. Amin, Y. Zhang, C. T. Sawin, S. R. Evans, M. T. Hannan, D. P. Kiel, P. W.F. Wilson, and D. T. Felson Association of Hypogonadism and Estradiol Levels with Bone Mineral Density in Elderly Men from the Framingham Study Ann Intern Med, December 19, 2000; 133(12): 951 - 963. [Abstract] [Full Text] [PDF]

				M. S. Katz Geriatrics Grand Rounds: Eve's Rib, or a Revisionist View of Osteoporosis in Men J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2000; 55(10): 560M - 569. [Abstract] [Full Text]

				J M Kaufman, O Johnell, E Abadie, S Adami, M Audran, B Avouac, W B. Sedrine, G Calvo, J P Devogelaer, V Fuchs, et al. Background for studies on the treatment of male osteoporosis: state of the art Ann Rheum Dis, October 1, 2000; 59(10): 765 - 772. [Abstract] [Full Text]

				P. J. Snyder, H. Peachey, J. A. Berlin, P. Hannoush, G. Haddad, A. Dlewati, J. Santanna, L. Loh, D. A. Lenrow, J. H. Holmes, et al. Effects of Testosterone Replacement in Hypogonadal Men J. Clin. Endocrinol. Metab., August 1, 2000; 85(8): 2670 - 2677. [Abstract] [Full Text]

				D. Vanderschueren, L. Vandenput, S. Boonen, E. Van Herck, J. V. Swinnen, and R. Bouillon An Aged Rat Model of Partial Androgen Deficiency: Prevention of Both Loss of Bone and Lean Body Mass by Low-Dose Androgen Replacement Endocrinology, May 1, 2000; 141(5): 1642 - 1647. [Abstract] [Full Text] [PDF]

				K. Redlich, S. Ziegler, H. P Kiener, S. Spitzauer, P. Stohlawetz, P. Bernecker, F. Kainberger, S. Grampp, S. Kudlacek, W. Woloszczuk, et al. Bone mineral density and biochemical parameters of bone metabolism in female patients with systemic lupus erythematosus Ann Rheum Dis, April 1, 2000; 59(4): 308 - 310. [Abstract] [Full Text]

				D. C Gould, R. Petty, and H. S Jacobs For and against: The male menopause---does it exist? • For • Against BMJ, March 25, 2000; 320(7238): 858 - 861. [Full Text]

				Long-Term Consequences of Castration in Men: Lessons from the Skoptzy and the Eunuchs of the Chinese and Ottoman Courts J. Clin. Endocrinol. Metab., December 1, 1999; 84(12): 4324 - 4331. [Full Text]

				F. Gori, L. C. Hofbauer, C. A. Conover, and S. Khosla Effects of Androgens on the Insulin-Like Growth Factor System in an Androgen-Responsive Human Osteoblastic Cell Line Endocrinology, December 1, 1999; 140(12): 5579 - 5586. [Abstract] [Full Text]

				J. P. Bilezikian Osteoporosis in Men J. Clin. Endocrinol. Metab., October 1, 1999; 84(10): 3431 - 3434. [Full Text] [PDF]

				K. Wiren, E. Keenan, X. Zhang, B. Ramsey, and E. Orwoll Homologous Androgen Receptor Up-Regulation in Osteoblastic Cells May Be Associated with Enhanced Functional Androgen Responsiveness Endocrinology, July 1, 1999; 140(7): 3114 - 3124. [Abstract] [Full Text]

				P. J. Snyder, H. Peachey, P. Hannoush, J. A. Berlin, L. Loh, J. H. Holmes, A. Dlewati, J. Staley, J. Santanna, S. C. Kapoor, et al. Effect of Testosterone Treatment on Bone Mineral Density in Men Over 65 Years of Age J. Clin. Endocrinol. Metab., June 1, 1999; 84(6): 1966 - 1972. [Abstract] [Full Text]

				S. Khosla, L. J. Melton III, E. J. Atkinson, W. M. O’Fallon, G. G. Klee, and B. L. Riggs Relationship of Serum Sex Steroid Levels and Bone Turnover Markers with Bone Mineral Density in Men and Women: A Key Role for Bioavailable Estrogen J. Clin. Endocrinol. Metab., July 1, 1998; 83(7): 2266 - 2274. [Abstract] [Full Text]

				C. Di Somma, A. Colao, A. Di Sarno, M. Klain, M. L. Landi, G. Facciolli, R. Pivonello, N. Panza, M. Salvatore, and G. Lombardi Bone Marker and Bone Density Responses to Dopamine Agonist Therapy in Hyperprolactinemic Males J. Clin. Endocrinol. Metab., March 1, 1998; 83(3): 807 - 813. [Abstract] [Full Text]

				M. Galus Osteoporosis in Men Arch Intern Med, January 26, 1998; 158(2): 194 - 194. [Full Text] [PDF]

				C.-Y. Guo, T. H. Jones, and R. Eastell Treatment of Isolated Hypogonadotropic Hypogonadism Effect on Bone Mineral Density and Bone Turnover J. Clin. Endocrinol. Metab., February 1, 1997; 82(2): 658 - 665. [Abstract] [Full Text] [PDF]