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The Journal of Clinical Endocrinology & Metabolism Vol. 84, No. 6 1966-1972
Copyright © 1999 by The Endocrine Society

From the Clinical Research Centers

Effect of Testosterone Treatment on Bone Mineral Density in Men Over 65 Years of Age1

Peter J. Snyder, Helen Peachey, Peter Hannoush, Jesse A. Berlin, Louise Loh, John H. Holmes, Abdallah Dlewati, Janet Staley, Jill Santanna, Shiv C. Kapoor, Maurice F. Attie, John G. Haddad, Jr. and Brian L. Strom

Departments of Medicine (P.J.S., H.P., P.H., L.L., A.D., S.K., M.F.A., J.G.H., B.L.S.) and Biostatistics and Epidemiology (J.A.B., J.H.H., J.St., J.Sa., B.L.S.), University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104

Address all correspondence and requests for reprints to: Dr. Peter J. Snyder, 3450 Hamilton Walk, Philadelphia, Pennsylvania 19104-6087.

As men age, their serum testosterone concentrations decrease, as do their bone densities. Because bone density is also low in hypogonadal men, we hypothesized that increasing the serum testosterone concentrations of men over 65 yr to those found in young men would increase their bone densities.

We randomized 108 men over 65 yr of age to wear either a testosterone patch or a placebo patch double blindly for 36 months. We measured bone mineral density by dual energy x-ray absorptiometry before and during treatment. Ninety-six men completed the entire 36-month protocol.

The mean serum testosterone concentration in the men treated with testosterone increased from 367 ± 79 ng/dL (±SD; 12.7 ± 2.7 nmol/L) before treatment to 625 ± 249 ng/dL (21.7 ± 8.6 nmol/L; P < 0.001) at 6 months of treatment and remained at that level for the duration of the study. The mean bone mineral density of the lumbar spine increased (P < 0.001) in both the placebo-treated (2.5 ± 0.6%) and testosterone-treated (4.2 ± 0.8%) groups, but the mean changes did not differ between the groups. Linear regression analysis, however, demonstrated that the lower the pretreatment serum testosterone concentration, the greater the effect of testosterone treatment on lumbar spine bone density from 0–36 months (P = 0.02). This analysis showed a minimal effect (0.9 ± 1.0%) of testosterone treatment on bone mineral density for a pretreatment serum testosterone concentration of 400 ng/dL (13.9 nmol/L), but an increase of 5.9 ± 2.2% for a pretreatment testosterone concentration of 200 ng/dL (6.9 nmol/L).

Increasing the serum testosterone concentrations of normal men over 65 yr of age to the midnormal range for young men did not increase lumbar spine bone density overall, but did increase it in those men with low pretreatment serum testosterone concentrations.




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 J. Clin. Endocrinol. Metab.Home page
S. M. Harman, E. J. Metter, J. D. Tobin, J. Pearson, and M. R. Blackman
Longitudinal Effects of Aging on Serum Total and Free Testosterone Levels in Healthy Men
J. Clin. Endocrinol. Metab., February 1, 2001; 86(2): 724 - 731.
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 JRSMHome page
G. M Prelevic
Osteoporosis in men
J R Soc Med, January 12, 2001; 94(12): 620 - 623.
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 ANN INTERN MEDHome page
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.
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 ANN INTERN MEDHome page
R. S. Swerdloff and C. Wang
Androgens, Estrogens, and Bone in Men
Ann Intern Med, December 19, 2000; 133(12): 1002 - 1004.
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R. S. Swerdloff, C. Wang, G. Cunningham, A. Dobs, A. Iranmanesh, A. M. Matsumoto, P. J. Snyder, T. Weber, J. Longstreth, and N. Berman
Long-Term Pharmacokinetics of Transdermal Testosterone Gel in Hypogonadal Men
J. Clin. Endocrinol. Metab., December 1, 2000; 85(12): 4500 - 4510.
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 Journals of Gerontology Series A: Biological Sciences and Medical SciencesHome page
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.
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 Ann Rheum DisHome page
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.
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F. J. Hayes
Testosterone--Fountain of Youth or Drug of Abuse?
J. Clin. Endocrinol. Metab., September 1, 2000; 85(9): 3020 - 3023.
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A. W. van den Beld, F. H. de Jong, D. E. Grobbee, H. A. P. Pols, and S. W. J. Lamberts
Measures of Bioavailable Serum Testosterone and Estradiol and Their Relationships with Muscle Strength, Bone Density, and Body Composition in Elderly Men
J. Clin. Endocrinol. Metab., September 1, 2000; 85(9): 3276 - 3282.
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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.
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 J. Clin. Endocrinol. Metab.Home page
C. Wang, R. S. Swerdloff, A. Iranmanesh, A. Dobs, P. J. Snyder, G. Cunningham, A. M. Matsumoto, T. Weber, and N. Berman the Testosterone Gel Study Group
Transdermal Testosterone Gel Improves Sexual Function, Mood, Muscle Strength, and Body Composition Parameters in Hypogonadal Men
J. Clin. Endocrinol. Metab., August 1, 2000; 85(8): 2839 - 2853.
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 EndocrinologyHome page
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.
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 BMJHome page
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.
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 J. Clin. Endocrinol. Metab.Home page
R. Bross, M. Javanbakht, and S. Bhasin
Anabolic Interventions for Aging-Associated Sarcopenia
J. Clin. Endocrinol. Metab., October 1, 1999; 84(10): 3420 - 3430.
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 J. Clin. Endocrinol. Metab.Home page
A. Negro-Vilar
Selective Androgen Receptor Modulators (SARMs): A Novel Approach to Androgen Therapy for the New Millennium
J. Clin. Endocrinol. Metab., October 1, 1999; 84(10): 3459 - 3462.
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P. J. Snyder, H. Peachey, P. Hannoush, J. A. Berlin, L. Loh, D. A. Lenrow, J. H. Holmes, A. Dlewati, J. Santanna, C. J. Rosen, et al.
Effect of Testosterone Treatment on Body Composition and Muscle Strength in Men Over 65 Years of Age
J. Clin. Endocrinol. Metab., August 1, 1999; 84(8): 2647 - 2653.
[Abstract] [Full Text]


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