Bone mineral density in hypogonadal men remains low after long-term testosterone replacement.
OBJECTIVE
In 11 congenital hypogonadal men, the bone mineral density (BMD) values were determined to assess the effect of long-term androgen replacement therapy (ART) on skeletal integrity.


METHODS
Eleven congenital hypogonadal men, including 8 isolated gonadotropin deficiency patients, 2 Kallmann's syndrome and 1 vanishing testes syndrome were recruited and treated with 250 mg of testosterone enanthate intramuscularly every 4 weeks for 7-43 years (mean+/-SD: 21.5 +/-13 years). In these patients and a group of 10 healthy young men (controls), the whole and trabecular BMDs were examined at the distal end of radius by means of a peripheral quantitative computerized tomography device.


RESULTS
The whole radial BMD in hypogonadal men was significantly less in the patients than in the healthy men (498+/-115 and 725+/-134 mg/cm(3), respectively; P<0.01); the trabecular BMD was also lower in the hypogonadal men (199+/-80 and 375+/-89 mg/cm(3); P< 0.01). The whole radial BMD values in 10 of 11 hypogonadal men were at least 1 SD below the mean value for healthy young men; 2 hypogonadal men had BMD values more than 2.5 SD lower than the healthy mean. Additionally, the whole radial BMD showed a significant negative correlation with the patient's age at the initiation of ART (r = 0.748, P<0.01). The serum level of bone-specific alkaline phosphatase and the urinary level of deoxypyridinoline were not significantly different between the two groups.


CONCLUSIONS
Osteopenia persists in the hypogonadal men after long-term ART, suggesting that such patients have a persistent defect in bone development not alleviated by androgen replacement.
Ishizaka
Kazuhiro
K
Department of Urology, Kanto Central Hospital, Tokyo 158-8531, Japan. E-mail: kazzie@parkcity.ne.jp
Suzuki
Masahito
M
Kageyama
Yukio
Y
Kihara
Kazunori
K
Yoshida
Ken-Ichiro
K
D000328:Adult; D000367:Age Factors; D015519:Bone Density / Q000187:drug effects*; D003456:Cryptorchidism / Q000188:drug therapy; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000151:congenital / Q000188:drug therapy* / Q000503:physiopathology; D007273:Injections, Intramuscular; D017436:Kallmann Syndrome / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013739:Testosterone / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*
D013739:Testosterone; C004648:testosterone enanthate