MedicalResearch.com Interview with:
Tony M. Keaveny, Ph.D.
Professor, Departments of Mechanical Engineering and Bioengineering;
Co-Director, Berkeley BioMechanics Laboratory
University of California
Berkeley, CA 94720-1740
MedicalResearch.com: What is the background for this study?
Response: As men age, they experience decreased serum testosterone concentrations, decreased bone mineral density (BMD) and increased risk of fracture. While prior studies have been performed to determine the effect of testosterone treatment on bone in older men, for various reasons those studies have been inconclusive.
The goal of this study was to overcome past limitations in study design and determine if testosterone treatment — versus a placebo — in older men with low testosterone would improve the bone. Specifically, we used 3D quantitative CT scanning to measure changes in BMD and engineering “finite element analysis” to measure changes in the estimated bone strength, both at the spine and hip. The study was performed on over 200 older men (> age 65) who had confirmed low levels of serum testosterone.
MedicalResearch.com: What are the main findings?
Response: We found that, at both the spine and hip and compared to treatment with a placebo, testosterone treatment for 12 months did indeed increase the BMD as measured by quantitative CT and also increased the estimated bone strength. The effect was greater in the trabecular than cortical bone, and greater at the spine than hip. Increases in BMD were also detected by more traditional DXA BMD-imaging, but the effects were smaller than those measured by quantitative CT and finite element analysis. The effect size on BMD and bone strength was also related to the change in serum testosterone resulting from treatment.
MedicalResearch.com: What should readers take away from your report?
Response: In older men with low levels of serum testosterone, treatment with testosterone can increase bone mineral density and bone strength, particularly at the spine.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: We have not demonstrated that treatment with testosterone decreases rates of fractures — the current study was not designed to measure rates of fractures. Given the highly statistically significant nature of our current findings, our results would now justify a new clinical trial to test the hypothesis that testosterone treatment reduces fracture rates in older men who have low levels of serum testosterone.
Disclosures: Dr. Keaveny has consulted for Agnovos Healthcare, Amgen, and O.N. Diagnostics, and has equity in O.N. Diagnostics.
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Snyder PJ, Kopperdahl DL, Stephens-Shields AJ, Ellenberg SS, Cauley JA, Ensrud KE, Lewis CE, Barrett-Connor E, Schwartz AV, Lee DC, Bhasin S, Cunningham GR, Gill TM, Matsumoto AM, Swerdloff RS, Basaria S, Diem SJ, Wang C, Hou X, Cifelli D, Dougar D, Zeldow B, Bauer DC, Keaveny TM. Effect of Testosterone Treatment on Volumetric Bone Density and Strength in Older Men With Low TestosteroneA Controlled Clinical Trial. JAMA Intern Med. Published online February 21, 2017. doi:10.1001/jamainternmed.2016.9539
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