Original Article
Bone Mineral Density in Early-Onset Hypogonadism and the Effect of Hormonal Replacement

https://doi.org/10.1385/JCD:7:3:334Get rights and content

Abstract

Hypogonadism is associated with reduction of bone mineral density (BMD), especially if sex steroid deficiency occurs early in life. In this situation, the effect of hormonal replacement therapy on bone mass is controversial. We evaluated the BMD through dual-energy X-ray absorptiometry (DXA) in patients with genetically determined hypogonadism or hypogonadism acquired in adulthood. The results of the BMD of patients never treated (pretreatment) or under treatment were compared with population standards and were submitted to pair analysis. Thirty-three patients were evaluated: group 1: BMD evaluated pretreatment (24); group 2: BMD evaluated under treatment (21); group 3: BMD evaluated pretreatment and under treatment (12). In group 1, there was a significant reduction of bone mass in all regions, with no gender differences. In patients with concomitant growth hormone (GH) deficiency, the total body (−3.60) and lumbar spine (−4.10) BMDs were significantly reduced compared to patients without associated GH deficiency (−2.37 and −2.35, respectively). In group 2, a significant reduction of bone mass was detected in all regions. In group 3, the patients showed statistically significant improvement in BMD with hormonal replacement therapy in all regions in both sexes. We conclude that the early onset of hypogonadism reduces the BMD significantly. This effect is increased when there is associated GH deficiency. Gonadal steroid replacement therapy increases the BMD in all bone regions, and the increase is similar in both sexes. However, although hormone replacement improves bone mass, it still remains significantly lower in comparision with population standards.

References (59)

  • RM Neer

    Osteoporosis

  • O Arizaka et al.

    Effect of testosterone on bone density metabolism in adolescent

    Metabolism

    (1995)
  • MC Oliveira et al.

    Resultados da densitometria óssea em pacientes com hipogonadismo

    Arq Bras Endocrinol Metab

    (1995)
  • JS Finkelstein et al.

    Osteopenia in men with a history of delayed puberty

    N Engl J Med

    (1992)
  • K Biberoglu et al.

    Bone loss in young women with primary hypogonadism and prevention with calcitonin

    Gynecol Obstet Invest

    (1993)
  • C Wang et al.

    Sublingual testosterone replacement improves muscle mass and strength, decrease bone resorption, and increases bone formation markers in hypogonadal men—a clinical resarch center study

    J Clin Endocrinol Metab

    (1996)
  • S Lewin et al.

    Densidade mineral óssea vertebral e femoral de 724 mulheres brancas brasileiras: influência da idade e do peso corporal

    Rev Ass Med Brasil

    (1997)
  • RA Faulkner et al.

    Bone densitometry in Canadians 8–17 years of age

    Calcif Tissue Int

    (1996)
  • HR Genant et al.

    Quantitative computed tomography of vertebral spongiosa: a sensitive method for detecting early bone loss after oophorectomy

    Ann Intern Med

    (1982)
  • JS Finkelstein et al.

    Parathyroid hormone for the prevention of bone loss induced by estrogen deficiency

    N Engl J Med

    (1994)
  • MC Davies et al.

    Osteoporosis in Turner's syndrome and the other forms of amenorrhoea

    Clin Endocrinol

    (1995)
  • YM Maugars et al.

    Follow-up of bone mineral density in 27 cases of anorexia nervosa

    Eur J Endocrinol

    (1996)
  • Y Takahashi et al.

    Spinal and femoral bone mass accumulation during normal adolescence: comparison with female patients with sexual precocity and hypogonadism

    J Clin Endocrinol Metab

    (1996)
  • KK Miller et al.

    Amenorrheic bone loss

    J Clin Endocrinol Metab

    (1999)
  • MC Davies et al.

    Bone mineral loss in young women with amenorrhoea

    Br Med J

    (1990)
  • RM Shore et al.

    Skeletal demineralization in Turner's syndrome

    Calcif Tissue Int

    (1982)
  • MA Smith et al.

    Bone demineralization in patient with Turner's syndrome

    J Med Gen

    (1982)
  • JL Ross et al.

    Normal bone density of the wrist and spine and increased wrist fractures in girls with Turner's syndrome

    J Clin Endocrinol Metab

    (1991)
  • L Sylvén et al.

    Bone mineral density in middle-age women with Turner's syndrome

    Eur J Endocrinol

    (1995)
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