Relationship between Sex Hormone Levels; Bone Mineral Density and Bone Turnover Markers in Healthy Moroccan Men: a Cross-Sectional Study

ABSTRACT

Introduction: gonadal steroid hormones play a crucial role during skeletal growth and maturation in both men and women. The aim of this study is to evaluate the relationship of sex hormone levels; bone mineral density and biochemical markers of bone turnover in healthy Moroccan men. Methods: 142 Moroccan men who had no previous diagnosis of osteoporosis were enrolled prospectively in this cross-sectional study between December 2009 and August 2010. Also; subjects were excluded from the study if they had conditions affecting bone metabolism. Different biochemical parameters were assayed Testosterone; Estradiol; sex hormone binding globulin; Osteocalcin; vitamin D; crosslaps; intact parathyroid hormone and alkaline phosphatase. Dual-energy X-ray absorptiometry was used to measure the Bone mineral density (BMD) (g/cm2). Results: in this study; among the 142 Moroccan men; 29 (20.1%) had densitometry osteoporosis and the prevalence of vitamin D insufficiency was 94%. No correlation was found between Estradiol; Testosterone and bone mineral density but we found significant differences in the levels of Estradiol between patients with osteoporosis; osteopenia and normal patients. Bone mineral density at the lumbar spine was negatively correlated to hormone-binding globulin and positively correlated to free androgen index; free estrogen index and the Body mass index. BMD at the total hip was positively correlated to free androgen index; Body mass index and negatively correlated to sex hormone binding globulin; alkaline phosphatase; intact parathyroid hormone; osteocalcin; Crosslaps and age. Conclusion: our study showed that increasing age; intact parathyroid hormone and alkaline phosphatase levels and decreasing body mass index were the most important independent factors associated to the presence of a low BMD at the total hip. Increasing body mass index and free androgen index level were the most important independent factors associated to the presence of a low BMD at the lumbar spine. The combination of variable that best predicted the male osteoporosis is age; body mass index; alkaline phosphatase and cigarette smoking