Déficit de testosterona como factor de riesgo de fractura de cadera en hombres de edad avanzada / Testosterone-Deficiency as a Risk Factor for Hip Fracture in Eldery Men

Objetivos: La pérdida progresiva de la densidad mineral ósea debilita los huesos y aumenta la probabilidad de fracturas osteoporóticas. Es conocida la acción de los andrógenos en el mantenimiento de la densidad mineral ósea. Este hecho nos hace pensar que podría existir una relación entre los niveles de esteroides sexuales y la fracturas osteoporóticas de cadera. Material y métodos: Se realiza un estudio caso-control, donde los casos correspondieron a 54 varones con fractura de cadera, cuyos datos fueron apareados por edad con 54 controles varones. A todos los pacientes se les determinó niveles de testosterona total, globulina transportadora de hormonas sexuales, albúmina y estradiol para el cálculo de la testosterona libre y la testosterona biodisponible. Resultados: Los pacientes con fractura de cadera presentaron unos niveles de testosterona inferiores a los controles (8,74 n/mol/l frente a 11,16 nmol/l; p=0,116) al igual que de testosterona libre (155,1pmol/l frente a 204,4pmol/l; p=0,02). Los niveles de testosterona biodisponible fueron inferiores en pacientes con fractura de cadera (2,69nmol/l frente a 3,89nmol/l; p=0,002), siendo esta última el mejor predictor para fractura (OR: 1,58). Conclusiones: Los pacientes con fractura de cadera presentan unos niveles significativamente inferiores de testosterona libre calculada y biodisponible en nuestra población a estudio. Estos hallazgos sugieren que los niveles de testosterona libre y biodisponible son predictores independientes de fractura de cadera osteoporótica en pacientes de edad avanzada (AU)

Objetives: Progressive loss of bone mineral density weakens the bones and increases the probability of osteoporotic fractures. It is well known that sex steroids play a role in the maintenance of bone density. This fact makes us think there might be a correlation between sex steroid levels and osteoporotic hip fractures. Material and methods: A case-control study was performed. The cases were 54 men who suffered from hip fracture. They were compared with 54 age-matched male control subjects. Levels of total testosterone, sex hormone binding globuline, albumin and oestradiol were measured in all subjects in order to calculate free testosterone and bio-testosterone levels. Results: Men who suffered from hip fracture had lower serum total testosterone (8.74 nmol/L versus 11.16 nmol/L; p=0.116) and lower free testostenone (155.1pmol/L versus 204.4pmol/L; p=0.02) than control subjects. Bio-testosterone levels were lower in patients with hip fracture (2.69 nmol/L versus 3.89 nmol/L; p=0.002), being the latter the best fracture predictor (OR: 1.58). Conclusions: In our study population, men with hip fractures had significantly lower levels of calculated free testosterone and bio-testosterone. These findings suggest that free testosterone and bio-testosterone levels are independent predictors for osteoporotic hip fracture in eldery men (AU)

[Testosterone-deficiency as a risk factor for hip fracture in eldery men]. / Déficit de testosterona como factor de riesgo de fractura de cadera en hombres de edad avanzada.

OBJECTIVES: Progressive loss of bone mineral density weakens the bones and increases the probability of osteoporotic fractures. It is well known that sex steroids play a role in the maintenance of bone density. This fact makes us think there might be a correlation between sex steroid levels and osteoporotic hip fractures. MATERIAL AND METHODS: A case-control study was performed. The cases were 54 men who suffered from hip fracture. They were compared with 54 age-matched male control subjects. Levels of total testosterone, sex hormone binding globuline, albumin and oestradiol were measured in all subjects in order to calculate free testosterone and bio-testosterone levels. RESULTS: Men who suffered from hip fracture had lower serum total testosterone (8.74 nmol/L versus 11.16 nmol/L; p=0.116) and lower free testostenone (155.1pmol/L versus 204.4pmol/L; p=0.02) than control subjects. Bio-testosterone levels were lower in patients with hip fracture (2.69 nmol/L versus 3.89 nmol/L; p=0.002), being the latter the best fracture predictor (OR: 1.58). CONCLUSIONS: In our study population, men with hip fractures had significantly lower levels of calculated free testosterone and bio-testosterone. These findings suggest that free testosterone and bio-testosterone levels are independent predictors for osteoporotic hip fracture in eldery men.