Androgenous state in patients presenting with osteoporosis

Androgen deficiency may cause secondary osteoporosis in men. The purpose of our study was to determine, as part of differential diagnosis, the con­ centrations of total testosterone, LH and estradiol in men presenting with newly diagnosed idiopathic osteoporosis and osteopenia. In a group of 57 men, mean age 54 years, presenting with idiopathic osteoporosis and densitometrically established osteopenia we determined serum concentra­ tions of total testosterone, LH and estradiol. We did not find the upper limit of normal serum testosterone levels in any of the patients - actually none of the patients presented even 75 % of the physiological range. In 89 % of the patients testosterone was lower than the mean of the physiological range and in 4 patients the testoserone values were below the lower limit of normal values. LH values were in 91 % of the patients within the normal range. 1 patient had a somewhat lower LH value, while in 4 of them this value was higher than normal values. 90 % of the patients had normal estradiol va­ lues, 3 had somewhat higher values. We could not confirm clinical manifestations of hypogonadism in our set of patients. Our results indicate that the determination of total testosterone, which in contrast to its free fraction does not express the appropriate androgenous condition, is not necessarily a contribution to the routine diagnosis of male osteoporosis. Lower total testosterone values, which remain within the normal range, indicate a possible role of androgens in the development of osteoporosis in the male population.