Journal of Clinical Endocrinology & Metabolism, Vol 69, 776-783, Copyright © 1989 by Endocrine Society

ARTICLES

Increases in bone density during treatment of men with idiopathic hypogonadotropic hypogonadism

JS Finkelstein, A Klibanski, RM Neer, SH Doppelt, DI Rosenthal, GV Segre and WF Crowley Jr
Department of Medicine, Massachusetts General Hospital, Boston 02114.

To assess the effects of gonadal steroid replacement on bone density in men with osteoporosis due to severe hypogonadism, we measured cortical bone density in the distal radius by 125I photon absorptiometry and trabecular bone density in the lumbar spine by quantitative computed tomography in 21 men with isolated GnRH deficiency while serum testosterone levels were maintained in the normal adult male range for 12-31 months (mean +/- SE, 23.7 +/- 1.1). In men who initially had fused epiphyses (n = 15), cortical bone density increased from 0.71 +/- 0.02 to 0.74 +/- 0.01 g/cm2 (P less than 0.01), while trabecular bone density did not change (116 +/- 9 compared with 119 +/- 7 mg/cm3). In men who initially had open epiphyses (n = 6), cortical bone density increased from 0.62 +/- 0.01 to 0.70 +/- 0.03 g/cm2 (P less than 0.01), while trabecular bone density increased from 96 +/- 13 to 109 +/- 12 mg/cm3 (P less than 0.01). Cortical bone density increased 0.03 +/- 0.01 g/cm2 in men with fused epiphyses and 0.08 +/- 0.02 g/cm2 in men with open epiphyses (P less than 0.05). Despite these increases, neither cortical nor trabecular bone density returned to normal levels. Histomorphometric analyses of iliac crest bone biopsies demonstrated that most of the men had low turnover osteoporosis, although some men had normal to high turnover osteoporosis. We conclude that bone density increases during gonadal steroid replacement of GnRH-deficient men, particularly in men who are skeletally immature.

This article has been cited by other articles:

				Z. Chakhtoura, A. Bachelot, D. Samara-Boustani, J.-C. Ruiz, B. Donadille, J. Dulon, S. Christin-Maitre, C. Bouvattier, M.-C. Raux-Demay, P. Bouchard, et al. Impact of total cumulative glucocorticoid dose on bone mineral density in patients with 21-hydroxylase deficiency. Eur. J. Endocrinol., June 1, 2008; 158(6): 879 - 887. [Abstract] [Full Text] [PDF]

				P. R. Ebeling Osteoporosis in Men N. Engl. J. Med., April 3, 2008; 358(14): 1474 - 1482. [Full Text] [PDF]

				N J Shaw Osteoporosis in paediatrics Arch. Dis. Child. Ed. Pract., December 1, 2007; 92(6): 169 - 175. [Full Text] [PDF]

				F Albaaj, M Sivalingham, P Haynes, G McKinnon, R N Foley, S Waldek, D J O'Donoghue, and P A Kalra Prevalence of hypogonadism in male patients with renal failure. Postgrad. Med. J., October 1, 2006; 82(972): 693 - 696. [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]

				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]

				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]

				T. Fujita, J. Ohtani, M. Shigekawa, T. Kawata, M. Kaku, S. Kohno, K. Tsutsui, K. Tenjo, M. Motokawa, Y. Tohma, et al. Effects of Sex Hormone Disturbances on Craniofacial Growth in Newborn Mice J. Dent. Res., March 1, 2004; 83(3): 250 - 254. [Abstract] [Full Text] [PDF]

				R. A. Anderson, A. M. Wallace, N. Sattar, N. Kumar, and K. Sundaram Evidence for Tissue Selectivity of the Synthetic Androgen 7{alpha}-Methyl-19-Nortestosterone in Hypogonadal Men J. Clin. Endocrinol. Metab., June 1, 2003; 88(6): 2784 - 2793. [Abstract] [Full Text] [PDF]

				C S Haworth, P L Selby, A W Horrocks, E B Mawer, J E Adams, and A K Webb A prospective study of change in bone mineral density over one year in adults with cystic fibrosis Thorax, August 1, 2002; 57(8): 719 - 723. [Abstract] [Full Text] [PDF]

				D. L. Andress, J. Ozuna, D. Tirschwell, L. Grande, M. Johnson, A. F. Jacobson, and W. Spain Antiepileptic Drug-Induced Bone Loss in Young Male Patients Who Have Seizures Arch Neurol, May 1, 2002; 59(5): 781 - 786. [Abstract] [Full Text] [PDF]

				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]

				M. R. Smith, F. J. McGovern, A. L. Zietman, M. A. Fallon, D. L. Hayden, D. A. Schoenfeld, P. W. Kantoff, and J. S. Finkelstein Pamidronate to Prevent Bone Loss during Androgen-Deprivation Therapy for Prostate Cancer N. Engl. J. Med., September 27, 2001; 345(13): 948 - 955. [Abstract] [Full Text] [PDF]

				W. P. Fairfield, J. S. Finkelstein, A. Klibanski, and S. K. Grinspoon Osteopenia in Eugonadal Men with Acquired Immune Deficiency Syndrome Wasting Syndrome J. Clin. Endocrinol. Metab., May 1, 2001; 86(5): 2020 - 2026. [Abstract] [Full Text]

				A. M. Kenny, K. M. Prestwood, C. A. Gruman, K. M. Marcello, and L. G. Raisz Effects of Transdermal Testosterone on Bone and Muscle in Older Men With Low Bioavailable Testosterone Levels J. Gerontol. A Biol. Sci. Med. Sci., May 1, 2001; 56(5): 266M - 272. [Abstract] [Full Text]

				B. Z. Leder, M. R. Smith, M. A. Fallon, M.-L. T. Lee, and J. S. Finkelstein Effects of Gonadal Steroid Suppression on Skeletal Sensitivity to Parathyroid Hormone in Men J. Clin. Endocrinol. Metab., February 1, 2001; 86(2): 511 - 516. [Abstract] [Full Text]

				G. M Prelevic Osteoporosis in men J R Soc Med, January 12, 2001; 94(12): 620 - 623. [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]

				L. A. Soyka, W. P. Fairfield, and A. Klibanski Hormonal Determinants and Disorders of Peak Bone Mass in Children J. Clin. Endocrinol. Metab., November 1, 2000; 85(11): 3951 - 3963. [Full Text]

				A. M. Kenny, K. M. Prestwood, K. M. Marcello, and L. G. Raisz Determinants of Bone Density in Healthy Older Men With Low Testosterone Levels J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2000; 55(9): 492M - 497. [Abstract] [Full Text]

				M. Thearle, M. Horlick, J. P. Bilezikian, J. Levy, J. M. Gertner, L. S. Levine, M. Harbison, W. Berdon, and S. E. Oberfield Osteoporosis: An Unusual Presentation of Childhood Crohn's Disease J. Clin. Endocrinol. Metab., June 1, 2000; 85(6): 2122 - 2126. [Abstract] [Full Text]

				S. L. Greenspan A 73-Year-Old Woman With Osteoporosis JAMA, April 28, 1999; 281(16): 1531 - 1540. [Full Text] [PDF]

				Replacing testosterone in men DTB, January 1, 1999; 37(1): 3 - 6. [Abstract] [Full Text] [PDF]

				S. B. Seminara, F. J. Hayes, and W. F. Crowley Jr. Gonadotropin-Releasing Hormone Deficiency in the Human (Idiopathic Hypogonadotropic Hypogonadism and Kallmann's Syndrome): Pathophysiological and Genetic Considerations Endocr. Rev., October 1, 1998; 19(5): 521 - 539. [Abstract] [Full Text]

				E. O. Abu, A. Horner, V. Kusec, J. T. Triffitt, and J. E. Compston The Localization of Androgen Receptors in Human Bone J. Clin. Endocrinol. Metab., October 1, 1997; 82(10): 3493 - 3497. [Abstract] [Full Text] [PDF]

				S. Dagogo-Jack, N. Al-Ali, and M. Qurttom Augmentation of Bone Mineral Density in Hirsute Women J. Clin. Endocrinol. Metab., September 1, 1997; 82(9): 2821 - 2825. [Abstract] [Full Text] [PDF]

				H. M. Behre, S. Kliesch, E. Leifke, T. M. Link, and E. Nieschlag Long-Term Effect of Testosterone Therapy on Bone Mineral Density in Hypogonadal Men J. Clin. Endocrinol. Metab., August 1, 1997; 82(8): 2386 - 2390. [Abstract] [Full Text] [PDF]

				R. Sih, J. E. Morley, F. E. Kaiser, H. M. Perry III, P. Patrick, and C. Ross Testosterone Replacement in Older Hypogonadal Men: A 12-Month Randomized Controlled Trial J. Clin. Endocrinol. Metab., June 1, 1997; 82(6): 1661 - 1667. [Abstract] [Full Text] [PDF]

				K. M. Wiren, X. Zhang, C. Chang, E. Keenan, and E. S. Orwoll Transcriptional Up-Regulation of the Human Androgen Receptor by Androgen in Bone Cells Endocrinology, June 1, 1997; 138(6): 2291 - 2300. [Abstract] [Full Text] [PDF]

				D. Vanderschueren, E. Van Herck, J. Nijs, A. G. H. Ederveen, R. De Coster, and R. Bouillon Aromatase Inhibition Impairs Skeletal Modeling and Decreases Bone Mineral Density in Growing Male Rats Endocrinology, June 1, 1997; 138(6): 2301 - 2307. [Abstract] [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]