ECE2022 Poster Presentations Calcium and Bone (68 abstracts)
Testosterone supplementation and bone parameters, a systematic review and meta-analysis study
Walter Vena 1 , Giovanni Corona 2 , Alessandro Pizzocaro 1 , Vito Giagulli 3 , Davide Francomano 4 , Giulia Rastrelli 5 , Antonio Aversa 6 , Andrea Marcello Isidori 7 , Rosario Pivonello 8,9 , Linda Vignozzi 5 , Edoardo Mannucci 10 , Mario Maggi 11 & Alberto Ferlin 12
1Humanitas Research Hospital, Endocrinology, Diabetology and Andrology Unit, Rozzano (MI), Italy; 2Azienda Usl, Maggiore-Bellaria Hospital, Medical Department, Bologna, Italy; 3Santa Maria Hospital, GVM Care & Research, Bari, Italy; 4Madonna delle Grazie Hospital, Unit of Internal Medicine and Endocrinology, Velletri (RM), Italy; 5University of Florence, Andrology, Women’s Endocrinology and Gender Incongruence Unit - Department of Experimental and Clinical Biomedical Sciences, Florence, Italy; 6University Magna Graecia of Catanzaro, Catanzaro, Italy;, Department of Experimental and Clinical Medicine, Catanzaro, Italy; 7Sapienza University of Rome, Department of Experimental Medicine, Rome, Italy; 8Università Federico II di Napoli, Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Unità di Andrologia e Medicina della Riproduzione e della Sessualità Maschile e Femminile, Naples, Italy; 9University of Naples, Chair for Health Education and Sustainable Development, Naples, Italy; 10Azienda Ospedalireo Universitaria Careggi and University of Florence, Department of Diabetology, florence, Italy; 11University of Florence, Endocrinology Unit “Mario Serio” Mario Serio” Department of Experimental and Clinical Biomedical Sciences, Florence, Italy; 12 University of Padova, Department of Medicine, Unit of Andrology and Reproductive Medicine, Padova, Italy
Background: Testosterone (T) is essential for bone health during all ages, helping to achieve a proper peak bone mass and, later, to maintain bone density and strength. Guidelines on management of male osteoporosis recommend testosterone replacement in young-adult hypogonadal to prevent bone loss and anti-resorbitive drugs in case of high fracture risk, but the role of T replacement therapy (TRT) alone in subjects with late onset hypogonadism is still the object of an intense debate.
Methods: All observational studies and placebo-controlled or -uncontrolled randomized trials (RCTs) comparing the effect of TRT on different bone parameters were considered. Studies using androgens other than T, as well as studies with concomitant treatment with other hormones and drugs were also excluded, unless there was a clearly defined treatment arm that received only T treatment. Similarly, studies including only patients with genetic causes of male hypogonadism were excluded.
Results: Out of 349 articles, 36 were considered, including 3103 individuals with a mean trial duration of 66.6 weeks. TRT improves significantly areal bone mineral density (aBMD) at the spine (mean +2.6%, 2-5.1%, CI 95%;P= 0,026) and femoral neck (mean +3.6%, 1-6.1%, CI95%;P=0,020) levels in observational studies, whereas placebo controlled RTCs showed a positive effect of TRT only at lumber spine (+2.2%, 0.4-4.8%, CI 95%;P= 0,097) and when trials included only hypogonadal patients at baseline (total testosterone < 12 nM)(+5.2%, 0.7-9.7%, CI 95%;P= 0,024). The effects on aBMD were more evident in subjects with lower T levels at baseline and increased as a function of trial duration and a higher prevalence of diabetic subjects. Either T or estradiol increase at endpoint contributed to aBMD improvement. TRT was associated with a significant reduction of bone resorption markers in observational but not in controlled studies.
Conclusion: TRT alone is able to inhibit bone resorption and increase bone mass, particularly at the lumbar spine level and when the duration is long enough to allow the anabolic effect of T and estrogens on bone metabolism to take place. However, whether or not TRT is associated with a decreased risk of bone fractures remains to be established.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more