Prevalence of osteopenia and osteoporosis in middle-aged and older Korean men with testosterone deficiency syndrome: a cross-sectional study

Testosterone plays an important role in regulating fertility, muscle mass and bone density. Low bone mineral density has been reported in men with testosterone deficiency syndrome (TDS); however, there is limited research available on the prevalence of TDS. In this study, we aimed to determine the prevalence of osteoporosis and osteopenia in middle-aged and older men (n = 4707, age: 40–79 years) with TDS. Their total serum testosterone levels were measured, and TDS was defined as a testosterone level of ≤3.5 ng/mL. To assess bone mineral density, we used dual-energy X-ray absorptiometry to measure the density at the lumbar spine (L1–L4) and femoral neck (T-score: osteopenia ≤−1.0; osteoporosis ≤−2.5). We performed logistic regression analysis to calculate adjusted odds ratios (AORs) after adjusting for age, body mass index, physical activity and VO2peak (Volume oxygen peak). The results showed a significant difference in physical activity between men with TDS and those without TDS (NTDS) in both middle-aged and older age groups (p < 0.05). Among middle-aged men, the AOR for osteopenia in the lumbar spine was 1.2-fold higher (Confience interval, CI (Confidence interval), 1.017–2.698), and in the femoral neck, it was 1.3-fold higher (CI, 1.012–3.013) for individuals with TDS compared to those without TDS. In older men, the AOR for osteopenia in the femoral neck increased by 1.4-fold (CI, 1.029–2.530). In conclusion, our findings suggest that middle-aged men with TDS have a higher likelihood of experiencing osteopenia in both the lumbar spine and femoral neck, while older men are more likely to have osteopenia, specifically in the femoral neck, but not osteoporosis.

Testosterone deficiency syndrome; Bone mineral density; Osteoporosis; Osteopenia

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