Effect of testosterone treatment on the trabecular bone score in older men with low serum testosterone

J. A. Cauley, S. S. Ellenberg, A. V. Schwartz, K. E. Ensrud, T. M. Keaveny, P. J. Snyder

Research output: Contribution to journalArticlepeer-review

Abstract

The trabecular bone score (TBS) is an indirect measure of vertebral bone microarchitecture. Our objective was to examine the effect of testosterone treatment on TBS. One hundred and ninety-seven hypogonadal men were randomized to testosterone or placebo. After 12 months, there was no difference in the changes in TBS by randomized group.

INTRODUCTION: In the Bone Trial of the Testosterone Trials, testosterone treatment increased trabecular volumetric bone mineral density (vBMD) and increased estimated bone strength as determined by finite element analysis. The trabecular bone score (TBS) is an indirect measure of vertebral bone microarchitecture. TBS predicts fracture independent of lumbar spine areal (a) BMD. The objective of this study was to examine the effect of testosterone treatment on TBS compared to its effects on vBMD and aBMD.

METHODS: Two hundred and eleven men were enrolled in the Bone Trial of the Testosterone Trials. Of these, 197 men had 2 repeat TBS and vBMD measurements; 105 men were allocated to receive testosterone, and 92 men to placebo for 1 year. TBS, aBMD, and vBMD were assessed at baseline and month 12.

RESULTS: There was no difference in the percent change in TBS by randomized group: 1.6% (95% confidence intervals (CI) 0.2-3.9) in the testosterone group and 1.4% (95% CI -0.2, 3.1) in the placebo group. In contrast, vBMD increased by 6% (95% CI 4.5-7.5) in the testosterone group compared to 0.4% (95% CI -1.65-0.88) in the placebo groups.

CONCLUSIONS: TBS is not clinically useful in monitoring the 1-year effect of testosterone treatment on bone structure in older hypogonadal men.

Original languageEnglish (US)
Pages (from-to)2371-2375
Number of pages5
JournalOsteoporosis International
Volume32
Issue number11
Early online dateJun 2 2021
DOIs
StatePublished - Nov 2021

Bibliographical note

Funding Information:
JAC, SEE, TMK, KEE, AVS, and PJS report grants from the National Institutes of Health. In addition, PJS reports grants and nonfinancial support from AbbVie during the conduct of the study. TMK reports consulting for Amgen and O.N. Diagnostics and has equity in O.N. Diagnostics.

Publisher Copyright:
© 2021, International Osteoporosis Foundation and National Osteoporosis Foundation.

Keywords

  • Bone mineral density
  • Hypogonadal men
  • Testosterone treatment
  • Testosterone trials
  • Trabecular bone score (TBS)

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