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Bone Loss in Men with Steroid Induced Osteoporosis May Be Due to Low Oesetradiol Levels
A DGReview of :"Low circulating estradiol and adrenal androgens concentrations in men on glucocorticoids: A potential contributory factor in steroid-induced osteoporosis."
Metabolism: Clinical and Experimental
11/18/2002
By Veronica Rose
Low serum oestradiol levels may contribute to bone loss in men with steroid induced osteoporosis.
Dr. Geeta Hampson and colleagues from St. Thomas' Hospital and Guy's Hospital, in London, England, conducted a study to determine if reduced circulating oestradiol concentrations might be implicated in steroid- induced osteoporosis in men.
They divided 77 men into two groups for assessment of serum oestradiol and adrenal androgens (dehydroepiandrosterone sulfate and androstenedione). Group A included 38 men with idiopathic osteoporosis (mean age 57.7 years) and Group B included 39 men with steroid-induced osteoporosis (mean age 55.3 years).
In Group B, the researchers also evaluated the relationship between bone mineral density (BMD) and serum oestradiol.
Men with steroid-induced osteoporosis had a higher prevalence of low serum testosterone concentrations, which had a significant correlation with steroid dosage and oestradiol concentration. These men also had a significant correlation between BMD at the lumbar spine and serum oestradiol concentrations.
There was a high rate of low serum oestradiol concentrations (less than 48 pmol/L) in both groups (44.7 percent and 36 percent, respectively). Group B men had noticeably suppressed serum androstenedione concentrations (Group A: 4.99 nmol/L; Group B: 2.1 nmol/L).
Serum dehydroepiandrosterone sulfate levels were undetectable in 59 percent of men in Group B compared with 6 percent of Group A. There was a correlation between reductions in androstenedione and steroid dosage.
The researchers concluded that a marked suppression of adrenal androgens synthesis was exhibited in men with steroid-induced osteoporosis. The clinical relevance of these findings remains to be determined, they write.
Metabolism Nov 2002; Vol.51, No.11: pp 1458-1462
"Low circulating estradiol and adrenal androgens concentrations in men on glucocorticoids: A potential contributory factor in steroid-induced osteoporosis."
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