Elderly men with a history of distal radius fracture have significantly lower calcaneal bone density and free androgen index than age-matched controls

Abstract

Background: Age related bone loss is widely accepted as related to decreased serum levels of circulating sex hormones. Epidemiological data also show distal radius fractures in men to be a sensitive marker of bone fragility. The aim of this study was to assess if men with a history of distal radius fracture have lower bone mass density (BMD), lower free androgen index (FAI), lower total testosterone (T) and lower bio-available testosterone (Bio-T) than healthy age-matched controls. Patients and methods: A case-control study is based on consecutive cases treated for low energy distal radius fracture at our department and age-matched controls. Thirty-nine men treated between 1997–2004 and 45 age-matched controls underwent calcaneal bone density measurements (t-score) and analyses of T, Bio-T and serum hormone binding globulin (SHBG). Results: The fracture group had lower BMD (p < 0.01) and lower FAI (p = 0.01). Linear regression analysis showed a correlation between Bio-T and t-scores (p = 0.03). Using analysis of covariance, a significant difference with lower Bio-T in the fracture group was shown. Conclusion: Bio-T seems to correlate with BMD in elderly men and may serve as a marker for increased fracture risk in this patient group.

Keywords::

• Bone mineral density
• male
• fractures
• osteoporosis
• testosterone

Acknowledgements

The authors gratefully acknowledge the technical assistance of Lotta Lindh-Åstrand, reg.nurse and Ph.D. at the Department of Obstetrics and Gynecology and Inger Ericsson, reg nurse at the Department of Orthopaedic Surgery at the University Hospital of Linköping, Sweden. We also acknowledge the financial support from the County Council of Östergötland.

Declaration of interest: Financial support was received from the County Council of Östergötland.