Reproductive Hormones and Longitudinal Change in Bone Mineral Density and Incident Fracture Risk in Older Men: The Concord Health and Aging in Men Project.
The objectives of this study were to examine relationships between baseline levels of reproductive hormones in older men and (1) change in bone mineral density (BMD) over 5 years and (2) incident fractures over an average of 6 years' follow-up. A total of 1705 men aged 70 years and older from the Concord Health and Ageing in Men Project (CHAMP) study were assessed at baseline (2005-2007), 2 years follow-up (2007-2009), and 5 years follow-up (2010-2013). At baseline, testosterone (T), dihydrotestosterone (DHT), estradiol (E2), and estrone (E1) were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and sex hormone-binding globulin (SHBG), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) by immunoassay. Hip BMD was measured by dual X-ray absorptiometry (DXA) at all three time-points. Fracture data were collected at 4-monthly phone calls and verified radiographically. Statistical modeling was by general estimating equations and Cox model regression. Univariate analyses revealed inverse associations for serum SHBG, FSH, and LH and positive association for E1 but not DHT or E2 with BMD loss at the hip across the three time points. Serum levels of SHBG (β = -0.071), FSH (β = -0.085), LH (β = -0.070), and E1 (β = 0.107) remained significantly associated with BMD loss in multivariate-adjusted models; however, we were unable to identify any thresholds for accelerated BMD loss according to reproductive steroids. Incident fractures (all, n = 171; hip, n = 44; and nonvertebral, n = 139) were all significantly associated with serum SHBG, FSH, and LH levels in univariate models but none remained significantly associated in multivariate-adjusted model. Serum T, DHT, E2, and E1 levels were not associated with incident fractures in univariate or multivariate-adjusted analyses. In older men, lower serum SHBG, FSH, and LH and higher E1 levels protected against loss of BMD without increasing fracture rate. This means these reproductive variables may be considered as novel biomarkers of bone health during male aging.
School of Public Health, University of Sydney, Sydney, New South Wales, Australia.|Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia.
Benjumin
B
Hsu
School of Public Health, University of Sydney, Sydney, New South Wales, Australia.|Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia.|ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia.
Robert G
RG
Cumming
ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia.
Markus J
MJ
Seibel
Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia.
Vasi
V
Naganathan
Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia.
Fiona M
FM
Blyth
Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia.
Kerrin
K
Bleicher
Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia.
Aneesh
A
Dave
Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia.
David G
DG
Le Couteur
Centre of Education and Research on Ageing, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia.
Louise M
LM
Waite
ANZAC Research Institute, University of Sydney and Concord Hospital, Sydney, New South Wales, Australia.
David J
DJ
Handelsman
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D002853:Chromatography, Liquid; D013196:Dihydrotestosterone / Q000097:blood; D004958:Estradiol / Q000097:blood; D004970:Estrone / Q000097:blood; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D050723:Fractures, Bone / Q000097:blood* / Q000453:epidemiology; D006728:Hormones / Q000097:blood*; D006801:Humans; D007118:Immunoassay; D008137:Longitudinal Studies; D007986:Luteinizing Hormone / Q000378:metabolism; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D053719:Tandem Mass Spectrometry; D013739:Testosterone / Q000097:blood
D015415:Biomarkers; D006728:Hormones; D012738:Sex Hormone-Binding Globulin; D013196:Dihydrotestosterone; D004970:Estrone; D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone
AGING; BONE MINERAL DENSITY; EPIDEMIOLOGICAL STUDY; FRACTURE; REPRODUCTIVE HORMONE