Sydney: Elderly men with low levels of testosterone are more than twice as likely to suffer bone fractures as those with higher amounts of the sex hormone, researchers in Australia found.
A study of men at least 60 years old found a quarter had testosterone deficiency linked to a two-fold increase in the risk of bone fractures caused by osteoporosis, according to researchers at Sydney’s Garvan Institute of Medical Research. The finding may enable doctors to identify susceptible elderly men and devise strategies to prevent bone fractures.
Osteoporosis, when bones thin and break easily, affects 10 million Americans and is generally considered a women’s disease. While women’s bones become fragile after menopause when they stop producing estrogen, men’s weaken at a later age and can cause just as much damage. In Australia, 30 percent of the 110,000 osteoporosis-induced fractures that occur each year are in men.
John Eisman, Professor Medicine at the University of New South Wales and director of Garvan’s bone and mineral programme said: “Osteoporosis in men is basically ignored. This is something that gives us more insight into why they might have problems, why they might be likely to fracture.”
In the US, for example, two million men have the disease and another 12 million are at risk for it, the National Osteoporosis Foundation estimates. Treating patients with osteoporosis medicines including Eli Lilly & Co.’s Evista and Forteo, Merck & Co.’s Fosamax and Procter & Gamble Co.’s Actonel may prevent fragility fractures if the disease is diagnosed early, previous studies have shown.
Each year, about 329,000 hip fractures occur in the U.S. About 20 percent of the people die within six to 12 months after breaking hips, according to a study published in November in the Journal of the American Medical Association.
Men’s testosterone levels are usually about 300 to 1,000 nanograms per deciliter of blood, according to the U.S. National Institutes of Health. A quarter of men over 60 had levels of 294 nanograms or less in the Garvan study, which followed 609 men aged over 60 years between January 1989 and December 2005.
Even after adjusting for factors known to alter fracture risk, including age, weight, fracture history, smoking status and calcium intake, the risk of fracture was more than doubled in men with low testosterone compared with men with high levels of the hormone, according to the study. The results were published yesterday in the Archives of Internal Medicines.
“Men with lower testosterone might be getting a double whammy,” Eisman said. “Their bones are worse and their muscles are a bit weaker, both of which are likely then to contribute to their risk of fractures.”
While testosterone supplements may assist those deficient in the hormone, other treatments may also help, he said.
“Importantly, reducing alcohol consumption, avoiding smoking, maintaining an active lifestyle, getting sunlight exposure and eating a diet rich in calcium will also help to minimize risk,” Eisman said.
The research is part of the Dubbo Osteoporosis Epidemiology Study, which started in 1989 and recruited all men and women 60 years or older living in Dubbo, a regional city of 32,000 predominantly white people in Australia’s New South Wales state.