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      Osteoporosis in Male Hypogonadism: Responses to Androgen Substitution Differ among Men with Primary and Secondary Hypogonadism

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          Background: No randomized study exists comparing the effects of different modes of androgen substitution on bone mineral density (BMD). Methods: We performed a prospective, randomized, trial assigning 53 hypogonadal men to the following treatment groups: mesterolone 100 mg p.o. daily, testosterone undecanoate 160 mg p.o. daily, testosterone enanthate 250 mg i.m. every 21 days, or a single subcutaneous implantation of 1,200 mg crystalline testosterone. The BMD was determined by peripheral quantitative computed tomography. Results: At baseline, men with secondary hypogonadism (n = 33) had a lower BMD (–1.52 ± 0.23 SDS; Z-scores) than men with primary hypogonadism (n = 20, –0.87 ± 0.23 SDS, p < 0.01). In men with primary hypogonadism, the BMD increased dose dependently (crystalline testosterone +7.0 ± 1.3%, testosterone enanthate +4.8 ± 0.2%, testosterone undecanoate +3.4 ± 2.5%, mesterolone +0.8 ± 1.6%) after 6 months of therapy. Only secondary hypogonadal men treated with testosterone enanthate experienced an increase of the BMD. Conclusions: In primary hypogonadal men the BMD responds dose dependently to testosterone substitution, whereas in secondary hypogonadism only testosterone enanthate treatment significantly increased the BMD.

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          Most cited references 4

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          Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism

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            Testosterone Substitution Normalizes Elevated Serum Leptin Levels in Hypogonadal Men

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              Sex hormones and osteoporosis in men.


                Author and article information

                Horm Res Paediatr
                Hormone Research in Paediatrics
                S. Karger AG
                13 June 2003
                : 60
                : 1
                : 21-28
                aKlinik II und Poliklinik für Innere Medizin der Universität zu Köln, Köln, und bKlinik für Nuklearmedizin, Universitätsklinik Würzburg, Würzburg, Deutschland
                70823 Horm Res 2003;60:21–28
                © 2003 S. Karger AG, Basel

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                Page count
                Figures: 2, Tables: 3, References: 32, Pages: 8
                Original Paper


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