Article ; Online: The effect of testosterone treatment on bone mineral density in Klinefelter syndrome: A retrospective cohort study.
2023 Volume 11, Issue 7, Page(s) 1295–1302
Abstract: Background: Although Klinefelter syndrome (KS) is the most frequent sex-hormone disorder, there is ongoing uncertainty about the often associated sex-hormone deficiency, its impact on common comorbidities, and therefore about prevention and treatment. ... ...
| Abstract | Background: Although Klinefelter syndrome (KS) is the most frequent sex-hormone disorder, there is ongoing uncertainty about the often associated sex-hormone deficiency, its impact on common comorbidities, and therefore about prevention and treatment. In this study, we focus on bone loss, reported to occur in over 40% of KS patients, and the impact of testosterone replacement therapy (TRT) on this comorbidity. Objectives: This single-center retrospective cohort study in a tertiary hospital compared the effect of treatment with TRT to no TRT on evolution of bone mineral density (BMD) in KS patients. Methods: After a medical chart review, a total of 52 KS subjects were included in this study. BMD was measured by dual-energy X-ray absorptiometry (DXA) and expressed as T-scores. Results: The subjects were divided into three groups, according to TRT. In the subgroup that only started TRT after baseline measurements (mean age 31 years), we observed significant gain in BMD T-score at the lumbar spine (0.58 ± 0.60, p = 0.003; mean gain of 0.62% areal BMD per year) and total femur T-score (0.24 ± 0.39, p = 0.041; mean gain of 0.25% areal BMD per year) after a mean follow-up period of 7.5 years. Compared to untreated subjects, a significant difference in evolution was demonstrated at the lumbar level (+0.58 ± 0.60 vs. -0.14 ± 0.42, p = 0.007). In untreated subjects with normal testosterone levels, a loss of BMD (-0.27 ± 0.37, p = 0.029; mean loss of 0.49% areal BMD per year) at the femoral neck was measured. This decline was equal to the predicted loss seen in the general male population. Conclusion: TRT results in BMD gain in patients with KS with testosterone deficiency, mainly at the lumbar spine. However, this effect is limited (0.62% per year). Patients who were not treated with TRT because of sufficient endogenous testosterone levels, showed only the predicted age-related bone loss during follow-up. The need for TRT in maintaining bone health in KS should be evaluated on an individual basis according to the degree of sex steroid deficiency. |
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| MeSH term(s) | Humans ; Male ; Adult ; Bone Density ; Testosterone/therapeutic use ; Testosterone/pharmacology ; Klinefelter Syndrome/complications ; Klinefelter Syndrome/drug therapy ; Retrospective Studies ; Osteoporosis/prevention & control ; Absorptiometry, Photon/adverse effects ; Absorptiometry, Photon/methods ; Gonadal Steroid Hormones | |||||
| Chemical Substances | Testosterone (3XMK78S47O) ; Gonadal Steroid Hormones | |||||
| Language | English | |||||
| Publishing date | 2023-02-25 | |||||
| Publishing country | England | |||||
| Document type | Journal Article ; Research Support, Non-U.S. Gov't | |||||
| ZDB-ID | 2696108-8 | |||||
| ISSN | 2047-2927 ; 2047-2919 | |||||
| ISSN (online) | 2047-2927 | |||||
| ISSN | 2047-2919 | |||||
| DOI | 10.1111/andr.13411 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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