Effect of various drug treatments on bone density in hypogonadal men

Objective: To evaluate bone mass in hypogonadal men who received testosterone, alendronate, calcium and vitamin D for one year.Methodology: In this clinical trial 44 hypogonadal men were evaluated. For diagnosing of hypogonadism, serum LH, FSH, and testosterone levels of the patients were assessed using RIA method. Bone mineral density (BMD) was measured using dual energy x-ray absorptiometery (DXA) in lumbar spine (L2-L4) and femoral neck before treatment. All patients received 250 mg IM testosterone enanthate every 15-20 days. Patients with T score -1.5 received 70 mg oral Alendronate weekly, testosterone, 1gr elemental calcium and 400 U vitamin D daily. Patients with -1.5 T score -1 received calcium and vitamin D supplementation and testosterone. After one year of treatment Bone mineral density was measured again. Results were compared with pretreatment BMD and the healthy age and sex matched control group. Serum testosterone level was measured again during the treatment.Results: Forty four patients aged 18-57 years were included in this study. 25 of them completed the course of study after one year. The mean serum testosterone level was 0.5±0.5 ng/ml before the treatment. After one year, it increased to 5.5±3 ng/ml (PV=0.01). The mean bone mineral density in lumbar spine was 0.97±0.22 g/cm2 which differed significantly from the control group at baseline (1.017±0.12g/cm2) (PV=0.006). After one year, the mean BMD increased to 1.09�0.22g/cm2 (PV= 0.02), which showed no statistical significant difference with the control group (PV=0.13). The mean baseline BMD in femoral neck was 0.88�0.12 g/cm2, which showed no significant difference with the control group (0.92±0.10 g/cm2) (PV=0.45), the mean T score before treatment showed significant difference with the control group (PV=0.00). Bone mineral density in femoral neck increased to 0.97±0.13 g/cm2 after one year (PV=0.01). The mean annual change of BMD in lumbar spine and femoral neck was 12±8.4% and 10±7.2% respectively during one year treatment. Annual change of BMD showed no significant difference in all types of hypogonadism after one year (PV=0.34). There was no significant correlation between age and BMD level before treatment, BMD increment was higher in younger patients after treatment (PV=0.04).Conclusion: The results show that one year administrating testosterone, alendronate, calcium and vitamin D in hypogonadal men can increase BMD significantly in lumbar spine and femoral neck