Importance of gonadal steroids to bone mass in men with hyperprolactinemic hypogonadism.
OBJECTIVE
To determine the effects of alteration of gonadal steroids on bone mass in men with hyperprolactinemic hypogonadism.


METHODS
Prospective survey of patients for a median period of 33 months.


METHODS
Neuroendocrine clinical center of a referral-based university medical center.


METHODS
Reversal of hyperprolactinemia by bromocriptine therapy, transsphenoidal surgery, or radiation therapy, alone or in combination.


METHODS
Consecutive sample of 20 male patients with prolactin-secreting pituitary tumors.


RESULTS
In patients who had a reversal of hyperprolactinemia and a restoration of gonadal function, a significant increase in bone density of the radial shaft was noted (mean +/- SE, 0.77 +/- 0.03 to 0.84 +/- 0.03 g/cm2; P less than or equal to 0.05). These patients also had a minimal change in the density of vertebral bone (109 +/- 9 to 115 +/- 10 mg of potassium phosphate, dibasic/cm3). Patients who remained hypogonadal despite the reversal of hyperprolactinemia had no change in radial (0.76 +/- 0.03 to 0.76 +/- 0.04 g/cm2) or vertebral bone density (105 +/- 10 to 103 +/- 9 mg of potassium phosphate, dibasic/cm3). There was a positive correlation between the change in testosterone level and the change in radial (r = 0.67, P less than or equal to 0.003) or vertebral bone density (r = 0.70, P less than or equal to 0.003).


CONCLUSIONS
The reversal of hypogonadism, independent of the prolactin concentration, is associated with an improvement in bone mass. Our findings emphasize the importance of gonadal steroids in maintaining skeletal integrity in men.
Greenspan
S L
SL
Massachusetts General Hospital, Boston.
Oppenheim
D S
DS
Klibanski
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D006801:Humans; D006966:Hyperprolactinemia / Q000150:complications* / Q000628:therapy; D007006:Hypogonadism / Q000150:complications* / Q000628:therapy; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011877:Radionuclide Imaging; D011884:Radius / Q000000981:diagnostic imaging; D013739:Testosterone / Q000097:blood / Q000172:deficiency*
D013739:Testosterone