J Clin Endocrinol Metab. 2025 Aug 16:dgaf461. doi: 10.1210/clinem/dgaf461. Online ahead of print.
ABSTRACT
OBJECTIVE: To study bone turnover markers (BTM) and sex steroids in relation to Trabecular Bone Score (TBS) in men.
MATERIAL AND METHODS: Longitudinal, population-based study in 465 healthy men, aged 25-45 years at baseline. Lumbar spine TBS was calculated with TBS iNsight® version 4 (v19.4.1, core module, Medimaps, Pessac, France), which adjusts for soft tissue thickness correction via DXA measurements. Sex hormone binding globulin (SHBG), C-terminal telopeptide and pro collagen type 1 N-terminal propeptide were measured using immunoassays. Total testosterone (T) and estradiol (E2) were determined by liquid chromatography-tandem mass spectrometry, free T and free E2 calculated. Statistical analyses were conducted via linear mixed-effects modelling.
RESULTS: At baseline, TBS was positively associated with free testosterone (p=0.01), free estradiol and total estradiol (both p<0.001), but not with total testosterone nor with BTM. Over a follow-up of 12.5 years, TBS declined by 1.43% (p<0.001). Higher baseline BMI and trunk fat were predictive of greater decreases in TBS (p=0.01 and p=0.02). Baseline levels of sex steroids and BTM nor changes therein were associated with changes in TBS.
CONCLUSIONS: TBS already decreases in young and middle-aged healthy men, corroborating earlier studies showing early decrease of trabecular bone volume and changes in trabecular microarchitecture. Although we identified some potentially contributing determinants, the underlying mechanisms of changes in TBS and trabecular bone in young men are yet to be fully elucidated.
PMID:40817832 | DOI:10.1210/clinem/dgaf461
