Anderson F H, Francis R M, Faulkner K
Musculoskeletal Unit, Freeman Hospital, Newcastle upon Tyne, UK.
Bone. 1996 Feb;18(2):171-7. doi: 10.1016/8756-3282(95)00441-6.
This open, prospective therapeutic trial studied the effects of regular moderate androgen supplementation on bone mineral density in eugonadal men with established osteoporosis, and collected data on the safety of androgen therapy used in this setting. 23 men, aged 34-73 years, with vertebral crush fractures and back pain, in whom secondary causes of osteoporosis had been excluded, were treated with fortnightly intramuscular injections of 250 mg testosterone esters (Sustanon 250(R)) for 6 months. Blood pressure was recorded monthly; fasting lipids, glucose, haematocrit, plasma viscosity, and testosterone levels were measured every 3 months. Psychological effects were assessed using the Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ), together with questioning on libido changes. Principal outcomes measured were changes in bone mineral density at the hip and spine by dual-energy X-ray absorptiometry (DEXA) over the treatment period. 21 men completed the study period. Mean bone mineral density at the lumbar spine increased from 0.799 g/cm(2) to 0.839 g/cm(2) during treatment (p < 0. 001), a rise of 5% in 6 months. Bone mineral density at the hip did not change. There were significant, favorable changes in diastolic blood pressure (-4.7 mmHg, p < 0.01), serum triglyceride levels (-0.405 mmol/L,p < 0.01), and total cholesterol (-0.27 mmol/L, p < 0.05). Adverse changes included a fall in HDL cholesterol (-0.087 mmol/L, p < 0.05) and a rise in plasma viscosity which was significant at 3 months but not at 6 months. The expected rises in hematocrit (0.434 to 0.456) and FAI (0.504 to 0.887) occurred. We conclude that testosterone supplementation significantly increased bone mineral density in this heterogeneous group of men with idiopathic primary osteoporosis, without an overall adverse effect on cardiovascular risk factors. This treatment warrants further evaluation in a randomized, controlled trial.
这项开放性前瞻性治疗试验研究了常规适度雄激素补充对患有确诊骨质疏松症的性腺功能正常男性骨矿物质密度的影响，并收集了在此情况下使用雄激素疗法的安全性数据。23名年龄在34 - 73岁之间、患有椎体压缩性骨折和背痛且已排除骨质疏松症继发原因的男性，接受每两周一次肌肉注射250毫克睾酮酯（Sustanon 250(R)）治疗，为期6个月。每月记录血压；每3个月测量空腹血脂、血糖、血细胞比容、血浆粘度和睾酮水平。使用医院焦虑抑郁量表（HADS）和一般健康问卷（GHQ）评估心理影响，并询问性欲变化。主要测量结果是在治疗期间通过双能X线吸收法（DEXA）测量的髋部和脊柱骨矿物质密度的变化。21名男性完成了研究期。治疗期间腰椎平均骨矿物质密度从0.799克/平方厘米增加到0.839克/平方厘米（p < 0.001），6个月内上升了5%。髋部骨矿物质密度没有变化。舒张压（-4.7 mmHg，p < 0.01）、血清甘油三酯水平（-0.405 mmol/L，p < 0.01）和总胆固醇（-0.27 mmol/L，p < 0.05）有显著的有利变化。不良变化包括高密度脂蛋白胆固醇下降（-0.087 mmol/L，p < 0.05）和血浆粘度升高，在3个月时显著，但在6个月时不显著。血细胞比容（从0.434到0.456）和游离雄激素指数（从0.504到0.887）出现了预期的升高。我们得出结论，在这群异质性特发性原发性骨质疏松症男性中，补充睾酮显著增加了骨矿物质密度，且对心血管危险因素没有总体不良影响。这种治疗方法值得在随机对照试验中进一步评估。
