Low serum estradiol found to have a causal effect on bone mineral density and fracture risk in men vs low testosterone, according to a new study.
Reference: Nethander M, Vandenput L, Eriksson AL, et al. Evidence of a causal effect of estradiol on fracture risk in men. J Clin Endocrinol Metab. 2018.
Maria Nethander and colleagues in Sweden found that low serum estradiol (E2) had a causal effect on bone mineral density and fracture risk in men while low testosterone (T) did not. Click through the slides above for details on their study and take home messages for physicians.
Sex Steroids and Male Bone Health. Observational human and animal studies have shown serum E2 is more closely associated with bone mass and strength in men vs serum T, however, the absence of randomized investigations has prevented determination of causality. Authors of the study used Mendelian randomization design to determine the effect of genetically lowered E2 or T levels on eBMD and fracture risk in European men.
The Study. A genome-wide association study and meta-analysis led to the current study that utilized MR instrument for E2 and T, to look at SNPs in 175 583 UK men. Authors used quantitative ultrasound of the heel to obtain non-invasive eBMD to predict fracture risk. Authors assessed the effects of the SNPs on eBMD and fractures, weighting the effect of each SNP by the magnitude of its effect on E2 or T levels.
The Results (cont.):
Take Home Points: