This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sobel, V. Articles by Imperato-McGinley, J. Search for Related Content PubMed PubMed Citation Articles by Sobel, V. Articles by Imperato-McGinley, J. Pubmed/NCBI databases OMIM Compound via MeSH Substance via MeSH Hazardous Substances DB TESTOSTERONE Related Collections Calcium and Bone Metabolism Male Endocrinology

Bone Mineral Density in the Complete Androgen Insensitivity and 5-Reductase-2 Deficiency Syndromes

Division of Endocrinology, Diabetes and Metabolism (V.S., Y.-S.Z., J.J.C., J.I.-M.), Department of Medicine, Weill Medical College of Cornell University, New York, New York 10021; and North Shore University Hospital (B.S.), Manhasset, New York 11030

Address all correspondence and requests for reprints to: Dr. Julianne Imperato-McGinley, Division of Endocrinology and Metabolism, 1300 York Avenue, New York, New York 10021. E-mail: jimperat{at}med.cornell.edu.

Context: Subjects with complete androgen insensitivity (CAI) and 5-reductase-2 deficiency (5RD-2) are natural human models to study the direct effect of androgens on bone mineral density (BMD).

Objective: The objective of this study was to test the hypothesis that androgens have a direct effect on BMD in men.

Design: This was a prospective, observational study (1989–1999) using dual energy x-ray absorptiometry.

Setting: The study was set in an outpatient specialty referral center.

Patients or Other Participants: All known subjects with these conditions (12 CAI and 16 5RD-2) from diverse sociodemographic backgrounds were recruited for the study.

Interventions: There were no interventions.

Main Outcome Measure: Mean Z score and weight-matched Z score at lumbar spine and femoral neck for CAI and 5RD-2 subjects were determined.

Results: Twelve CAI subjects had mean Z score at L2–L4 of –2.84 (±0.97, P < 0.001) and a mean weight-matched Z score of –2.52 (±0.94, P < 0.001). The mean Z score at the femoral neck was –1.33 (±0.91, P < 0.001) and the mean weight-matched Z score was –1.10 (±0.82, P = 0.001). Sixteen 5RD-2 subjects had a mean Z score at L2–L4 of –0.84 (±1.29, P = 0.02) and a mean weight-matched Z score for 15 of 16 patients of –0.44 (±1.08, P = 0.14). The mean Z score at the femoral neck was 0.14 (±1.02, P = 0.58) and the mean weight-matched Z score for 15 of 16 patients was 0.49 (±0.94, P = 0.06). Therefore, in CAI subjects, BMD was significantly decreased in the spine and hip. 5RD-2 subjects had normal BMD values.

Conclusions: 1) Androgens are of direct importance in the development and/or maintenance of BMD; and 2) testosterone and/or low levels of dihydrotestosterone appear to be sufficient for BMD development and/or maintenance.

This article has been cited by other articles:

				S. J. Jacobsen, T. C. Cheetham, R. Haque, J. M. Shi, and R. K. Loo Association Between 5-{alpha} Reductase Inhibition and Risk of Hip Fracture JAMA, October 8, 2008; 300(14): 1660 - 1664. [Abstract] [Full Text] [PDF]