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 Estradiol,
Testosterone,
and Hip Fractures in Men
Researchers writing in The American Journal of Medicine
say "Men with low estradiol levels are at an increased risk for future
hip fracture. Men with both low estradiol and low testosterone levels
seem to be at greatest risk for hip fracture." |
Estradiol,
Testosterone, and Hip Fractures in Men.
Shreyasee A, Zhang Y, Felson DT,
Sawin CT, Hannan MT, Wilson PWF, Kiel DP. Estradiol, Testosterone, and
the Risk for Hip Fractures in Elderly Men from the Framingham Study. The
American Journal of Medicine Volume 119, Issue 5 , May 2006, Pages
426-433
From the article abstract
Background
Low serum estradiol has been more strongly associated with low
bone mineral density in elderly men than has testosterone, but
its association with incident hip fracture is unknown. We
examined whether low estradiol increases the risk for future hip
fracture among men and explored whether testosterone levels
influence this risk.
Methods
We examined 793 men (mean age = 71 years) evaluated between 1981
and 1983, who had estradiol measures and no history of hip
fracture, and followed until the end of 1999. Total estradiol
and testosterone were measured between 1981 and 1983. Hip
fractures were identified and confirmed through medical records
review through the end of 1999. We created 3 groups of men based
on estradiol levels and performed a Cox-proportional hazards
model to examine the risk for incident hip fracture, adjusted
for age, body mass index, height, and smoking status. We
performed similar analyses based on testosterone levels, and
then based on both estradiol and testosterone levels together.
Results
There were 39 men who sustained an atraumatic hip fracture over
follow-up. Incidence rates for hip fracture (per 1000
person-years) were 11.0, 3.4, and 3.9 for the low (2.0-18.1 pg/mL
[7-67 pmol/L]), middle (18.2-34.2 pg/mL [67-125 pmol/L]), and
high (≥34.3 pg/mL [≥126 pmol/L]) estradiol groups, respectively.
With adjustment for age, body mass index, height, and smoking
status, the adjusted hazard ratios for men in the low and middle
estradiol groups, relative to the high group, were 3.1 (95%
confidence interval [CI], 1.4-6.9) and 0.9 (95% CI, 0.4-2.0),
respectively. In similar adjusted analyses evaluating men by
their testosterone levels, we found no significant increased
risk for hip fracture. However, in analyses in which we grouped
men by both estradiol and testosterone levels, we found that men
with both low estradiol and low testosterone levels had the
greatest risk for hip fracture (adjusted hazard ratio: 6.5, 95%
CI, 2.9-14.3).
Conclusion
Men with low estradiol levels are at an
increased risk for future hip fracture. Men with both low
estradiol and low testosterone levels seem to be at greatest
risk for hip fracture.
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