Testosterone supplementation and bone parameters: a systematic review and meta-analysis study.

Abstract

BACKGROUND:

The role of testosterone (T) replacement therapy (TRT) 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.

RESULTS:

Out of 349 articles, 36 were considered, including 3103 individuals with a mean trial duration of 66.6 weeks. TRT improves areal bone mineral density (aBMD) at the spine and femoral neck levels in observational studies, whereas placebo-controlled RTCs showed a positive effect of TRT only at lumber spine and when trials included only hypogonadal patients at baseline (total testosterone < 12 nM). 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 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.

• Authors: G Corona, W Vena, A Pizzocaro, V A Giagulli, D Francomano, G Rastrelli, G Mazziotti, A Aversa, A M Isidori, R Pivonello, L Vignozzi, E Mannucci, M Maggi, A Ferlin
• Journal: Journal of endocrinological investigation (J Endocrinol Invest) Vol. 45 Issue 5 Pg. 911-926 (May 2022) ISSN: 1720-8386 [Electronic] Italy
• PMID: 35041193 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
• Copyright: © 2022. Italian Society of Endocrinology (SIE).

Chemical References

• Testosterone

Topics

• Bone Density
• Bone Resorption (complications)
• Dietary Supplements
• Femur Neck
• Hormone Replacement Therapy
• Humans
• Hypogonadism (drug therapy)
• Lumbar Vertebrae
• Testosterone (pharmacology, therapeutic use)