(799) Bone Health in Aging Men: It’s Not Just About Testosterone

Introduction Bone fractures due to reduced bone mineral density (BMD) in men with hypogonadism represent a significant factor in diminished quality of life. Testosterone plays a key role in maintaining BMD, but the relationship between total testosterone (TT) levels and the development of osteoporosis remains controversial. Objective This study aims to evaluate testosterone levels and BMD parameters (osteopenia and osteoporosis) and to assess their correlation with body mass index (BMI), abdominal circumference (AC), serum TT, estradiol (E2), total serum calcium (Ca), and the TT/E2 ratio in men over 60 years of age. Methods We reviewed men over 60 years of age who underwent dual-energy X-ray absorptiometry (DEXA) at two urology centers. Data collected included BMI, AC, serum TT, E2, total serum Ca, and the TT/E2 ratio. None of these participants were under testosterone replacement therapy (TRT) or ever used TRT during their life. These parameters were analyzed in relation to bone density findings from DEXA. Results The study included 273 patients with a mean age of 69.0 years (SD 6.12), mean BMI of 27.3 kg/m2 (SD 4.31), mean TT levels of 497 ng/dL (SD 226), mean E2 levels of 27.5 pg/mL (SD 12.1), mean Ca 9.36 (SD 0.386) and mean AC of 98.8 cm (SD 11.4). Significant correlations with DEXA were observed for higher levels of AC (t = 3.17, df = 189.26, p = 0.0018) and BMI (t = 3.21, df = 192.55, p = 0.0016). No significant associations were found between DEXA and TT (p = 0.1028), E2 (p = 0.8636), or TT/E2 ratio (p = 0.3601). Additionally, BMI was inversely associated with TT/E2 ratio (β = -0.5691, p = 0.0387). Conclusions Higher abdominal circumference and BMI showed significant associations with normal bone mineral density, underscoring their potential utility as clinical indicators of bone health. No significant correlations were found between BMD and total testosterone, estradiol, or the TT/E2 ratio, suggesting that hormonal levels alone may not predict bone loss in this population. The inverse relationship between BMI and the TT/E2 ratio also highlights the metabolic impact of adiposity on hormonal profiles. These findings support the need for a multifactorial approach to osteoporosis risk assessment in aging men. Disclosure No