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/cm 2 ). 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.

Correlation between Sex Hormone Deficiency and Osteoarthritis

“…There are also other examples of the involvement of aromatase in bone metabolism. The correlation between Estradiol and bone remodelling biomarkers has been proposed by a study where elderly men treated with an aromatase inhibitor displayed a significant increase in bone resorption as well as decreased bone formation biomarkers; once again suggesting that aromatase in combination with steroid precursors is relevant to bone health, especially in aged individuals [6].…”

“…The pathological changes involved in the progression of OA are caused by biomechanical forces as well as multiple autocrine, paracrine and endocrine cellular events which all contribute to perturbations of tissue homeostasis within the affected joint [4], [5]. Gonadal steroid hormones, such as Estrogen (E) and Testosterone (T), for example, are molecules that are biosynthesized in the body and play a key role in sexual development and reproduction, which includes regulating the vital process of skeletal growth and maturation, among other natural developmental processes in both men and women [6]. Sex hormones control the development of cartilage and bone as well as homeostasis according to sex.…”

Epidemiology and awareness of osteoporosis: a viewpoint from the Middle East and North Africa

“…Environmental exposure: The relationship between smoking exposure and OP remains controversial; smoking was not associated with OP [28,49] while others considered cigarette smoking as a predictor for OP [43,56,73]. Among battery manufacturing workers, significant elevated levels of lead concentration were accompanied with OP when compared to healthy control.…”

“…Comparison between postmenopausal women according to their BMI showed that obese women had a higher BMD and lower prevalence of vertebral fractures [33,75]. Physical inactivity and low BMI are major risk factors of low BMD in both women and men [13,43,56,57,65,76].…”

Assessing the Associations of Blood Metabolites With Osteoporosis: A Mendelian Randomization Study

“…A recent study observed novel metabolic profiling in postmenopausal women with a low BMD (16). Another prospective study suggested that intact parathyroid hormone and alkaline phosphatase levels were the most important independent factors associated with low BMD of the hip (17). To the best of our knowledge, no largescale study has been conducted to evaluate the relationship between global blood metabolites and osteoporosis.…”