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Pätzug K, Friedrich N, Kische H, Hannemann A, Völzke H, Nauck M, Keevil BG, Haring R. Sex hormones and quantitative ultrasound parameters at the heel in men and women from the general population. Bone Rep 2017; 7:51-56. [PMID: 28875157 PMCID: PMC5574814 DOI: 10.1016/j.bonr.2017.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 08/15/2017] [Accepted: 08/17/2017] [Indexed: 11/28/2022] Open
Abstract
Purpose/introduction The present study investigates potential associations between liquid chromatography-mass spectrometry (LC-MS) measured sex hormones, dehydroepiandrosterone sulphate, sex hormone-binding globulin (SHBG) and bone ultrasound parameters at the heel in men and women from the general population. Methods Data from 502 women and 425 men from the population-based Study of Health in Pomerania (SHIP-TREND) were used. Cross-sectional associations of sex hormones including testosterone (TT), calculated free testosterone (FT), dehydroepiandrosterone sulphate (DHEAS), androstenedione (ASD), estrone (E1) and SHBG with quantitative ultrasound (QUS) parameters at the heel, including broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness index (SI) were examined by analysis of variance (ANOVA) and multivariable quantile regression models. Results Multivariable regression analysis showed a sex-specific inverse association of DHEAS with SI in men (Beta per SI unit = − 3.08, standard error (SE) = 0.88), but not in women (Beta = − 0.01, SE = 2.09). Furthermore, FT was positively associated with BUA in men (Beta per BUA unit = 29.0, SE = 10.1). None of the other sex hormones (ASD, E1) or SHBG was associated with QUS parameters after multivariable adjustment. Conclusions This cross-sectional population-based study revealed independent associations of DHEAS and FT with QUS parameters in men, suggesting a potential influence on male bone metabolism. The predictive role of DHEAS and FT as a marker for osteoporosis in men warrants further investigation in clinical trials and large-scale observational studies. Population-based data of healthy men and women from the general population Sex hormone panel measured by liquid chromatography-mass spectrometry (LC-MS) Associations of dehydroepiandrosterone sulphate and free testosterone with bone ultrasound parameters in men Estrone, androstenedione and SHBG were not associated with bone ultrasound parameters in both sexes.
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Key Words
- ANOVA, analysis of variance
- ASD, androstenedione
- BMD, bone mineral density
- BUA, broadband ultrasound attenuation
- Bone
- CI, confidence interval
- DHEAS
- DHEAS, dehydroepiandrosterone sulphate
- E1, estrone
- FT, free testosterone
- LC-MS, liquid chromatography-mass spectrometry
- QUS, quantitative ultrasound
- SE, standard error
- SHBG, sex hormone-binding globulin
- SHIP, Study of Health in Pomerania
- SI, stiffness index
- SOS, speed of sound
- Sex hormones
- Stiffness index
- TT, testosterone
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Affiliation(s)
- Konrad Pätzug
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - Hanna Kische
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Greifswald, Germany.,DZD (German Centre for Diabetes Research), Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Greifswald, Germany
| | - Brian G Keevil
- Department of Clinical Chemistry, University Hospital South Manchester, UK
| | - Robin Haring
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Germany.,European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Orwoll ES, Lapidus J, Wang PY, Vandenput L, Hoffman AR, Fink HA, Laughlin GA, Nethander M, Ljunggren Ö, Kindmark A, Lorentzon M, Karlsson M, Mellström D, Kwok A, Khosla S, Kwok T, Ohlsson C. The Limited Clinical Utility of Testosterone, Estradiol, and Sex Hormone Binding Globulin Measurements in the Prediction of Fracture Risk and Bone Loss in Older Men. J Bone Miner Res 2017; 32:633-640. [PMID: 27753150 PMCID: PMC5896330 DOI: 10.1002/jbmr.3021] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/05/2016] [Accepted: 10/16/2016] [Indexed: 01/08/2023]
Abstract
Measurement of serum testosterone (T) levels is recommended in the evaluation of osteoporosis in older men and estradiol (E2) and sex hormone binding globulin (SHBG) levels are associated with the rate of bone loss and fractures, but the clinical utility of sex steroid and SHBG measurements for the evaluation of osteoporosis in men has not been examined. To evaluate whether measurements of T, E2, and/or SHBG are useful for the prediction of fracture risk or the rate of bone loss in older men, we analyzed longitudinal data from 5487 community-based men participating in the Osteoporotic Fractures in Men (MrOS) study in the United States, Sweden, and Hong Kong. Serum T, E2, and SHBG levels were assessed at baseline; incident fractures were self-reported at 4-month intervals with radiographic verification (US), or ascertained via national health records (Sweden, Hong Kong). Rate of bone loss was assessed by serial measures of hip bone mineral density (BMD). We used receiver operating characteristic (ROC) curves, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) to assess improvement in prediction. Mean age at baseline was 72 to 75 years and the prevalence of low T levels (<300 ng/dL) was 7.6% to 21.3% in the three cohorts. There were 619 incident major osteoporotic and 266 hip fractures during follow-up of approximately 10 years. Based on ROC curves, there were no improvements in fracture risk discrimination for any biochemical measure when added to models, including the Fracture Risk Assessment Tool (FRAX) with BMD. Although minor improvements in NRI were observed for the dichotomous parameters low bioavailable E2 (BioE2) (<11.4 pg/mL) and high SHBG (>59.1 nM), neither sex steroids nor SHBG provided clinically useful improvement in fracture risk discrimination. Similarly, they did not contribute to the prediction of BMD change. In conclusion, there is limited clinical utility of serum E2, T, and SHBG measures for the evaluation of osteoporosis risk in elderly men. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Eric S. Orwoll
- Division of Endocrinology, Diabetes, and Clinical Nutrition – Bone and Mineral Unit, School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road CR 113, Portland, OR, USA 97239
| | - Jodi Lapidus
- Dept of Public Health and Preventive Medicine, Division of Biostatistics, Oregon Health & Science University, Portland, OR
| | - Patty Y. Wang
- Bone and Mineral Unit, Dept of Medicine, Oregon Health & Science University, Portland, OR
| | - Liesbeth Vandenput
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Howard A. Fink
- Geriatric Research Education & Clinical Center, VA Medical Center, Minneapolis, MN
- Dept of Medicine, University of Minnesota, Minneapolis, MN
| | - Gail A. Laughlin
- Division of Epidemiology, Dept of Family Medicine and Public Health, School of Medicine, University of California San Diego, La Jolla, CA
| | - Maria Nethander
- Bioinformatics Core Facility, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Östen Ljunggren
- Dept of Medical Sciences, University of Uppsala, Uppsala, Sweden
| | - Andreas Kindmark
- Dept of Medical Sciences, University of Uppsala, Uppsala, Sweden
| | - Mattias Lorentzon
- Centre for Bone and Arthritis Research and Dept of Geriatric Medicine, Inst of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Dept of Clinical Sciences, Lund University
- Dept of Orthopaedics, Malmö University Hospital, Malmö, Sweden
| | - Dan Mellström
- Centre for Bone and Arthritis Research and Dept of Geriatric Medicine, Inst of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anthony Kwok
- Department of Orthopaedics and Traumatology, and Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong
| | | | - Timothy Kwok
- Jockey Club Centre for Osteoporosis Care and Control, and Department of Medicine and Therapeutics, The Chinese University of Hong Kong
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Sinnesael M, Jardi F, Deboel L, Laurent MR, Dubois V, Zajac JD, Davey RA, Carmeliet G, Claessens F, Vanderschueren D. The androgen receptor has no direct antiresorptive actions in mouse osteoclasts. Mol Cell Endocrinol 2015; 411:198-206. [PMID: 25958043 DOI: 10.1016/j.mce.2015.04.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 04/29/2015] [Accepted: 04/29/2015] [Indexed: 12/31/2022]
Abstract
Androgen deficiency or androgen receptor knockout (ARKO) causes high-turnover osteopenia, but the target cells for this effect remain unclear. To examine whether AR in osteoclasts directly suppresses bone resorption, we crossed AR-floxed with cathepsin K-Cre mice. Osteoclast-specific ARKO (ocl-ARKO) mice showed no changes neither in osteoclast surface nor in bone microarchitecture nor in the response to orchidectomy and androgen replacement, indicating that the AR in osteoclasts is not critical for bone maintenance. In line with the lack of a bone phenotype, the levels of AR were very low in osteoclast-enriched cultures derived from bone marrow (BM) and undetectable in osteoclasts generated from spleen precursors. Since tibiae of ubiquitous ARKO mice displayed increased osteoclast counts, the role of AR was further explored using cell cultures from these animals. Osteoclast generation and activity in vitro were similar between ARKO and wildtype control (WT) mice. In co-culture experiments, BM stromal cells (BMSCs) were essential for the suppressive action of AR on osteoclastogenesis and osteoclast activity. Stimulation with 1,25(OH)2 vitamin D3 increased Rankl and decreased Tnfsf11 (osteoprotegerin, Opg) gene expression in BMSCs more than in osteoblasts. This increase in the Rankl/Opg ratio following 1,25(OH)2D3 stimulation was lower, not higher, in ARKO mice. Runx2 expression in BMSCs was however higher in ARKO vs. WT, suggesting that ARKO mice may more readily commit osteoprogenitor cells to osteoblastogenesis. In conclusion, the AR does not seem to suppress bone resorption through direct actions in osteoclasts. BMSCs may however represent an alternative AR target in the BM milieu.
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Affiliation(s)
- Mieke Sinnesael
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Ferran Jardi
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Ludo Deboel
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Michaël R Laurent
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium; Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Vanessa Dubois
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Jeffrey D Zajac
- Department of Medicine, Austin Health, University of Melbourne, Heidelberg, Victoria, Australia
| | - Rachel A Davey
- Department of Medicine, Austin Health, University of Melbourne, Heidelberg, Victoria, Australia
| | - Geert Carmeliet
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Frank Claessens
- Molecular Endocrinology Laboratory, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Dirk Vanderschueren
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium.
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