{"doi":"10.1210/clinem/dgab149","title":"Effect of Testosterone Treatment on Bone Microarchitecture and Bone Mineral Density in Men: A 2-Year RCT","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec>\n                  <jats:title>Context</jats:title>\n                  <jats:p>Testosterone treatment increases bone mineral density (BMD) in hypogonadal men. Effects on bone microarchitecture, a determinant of fracture risk, are unknown.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Objective</jats:title>\n                  <jats:p>We aimed to determine the effect of testosterone treatment on bone microarchitecture using high resolution–peripheral quantitative computed tomography (HR-pQCT).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Methods</jats:title>\n                  <jats:p>Men ≥ 50 years of age were recruited from 6 Australian centers and were randomized to receive injectable testosterone undecanoate or placebo over 2 years on the background of a community-based lifestyle program. The primary endpoint was cortical volumetric BMD (vBMD) at the distal tibia, measured using HR-pQCT in 177 men (1 center). Secondary endpoints included other HR-pQCT parameters and bone remodeling markers. Areal BMD (aBMD) was measured by dual-energy x-ray absorptiometry (DXA) in 601 men (5 centers). Using a linear mixed model for repeated measures, the mean adjusted differences (95% CI) at 12 and 24 months between groups are reported as treatment effect.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>Over 24 months, testosterone treatment, versus placebo, increased tibial cortical vBMD, 9.33 mg hydroxyapatite (HA)/cm3) (3.96, 14.71), P &amp;lt; 0.001 or 3.1% (1.2, 5.0); radial cortical vBMD, 8.96 mg HA/cm3 (3.30, 14.62), P = 0.005 or 2.9% (1.0, 4.9); total tibial vBMD, 4.16 mg HA/cm3 (2.14, 6.19), P &amp;lt; 0.001 or 1.3% (0.6, 1.9); and total radial vBMD, 4.42 mg HA/cm3 (1.67, 7.16), P = 0.002 or 1.8% (0.4, 2.0). Testosterone also significantly increased cortical area and thickness at both sites. Effects on trabecular architecture were minor. Testosterone reduced bone remodeling markers CTX, −48.1 ng/L [−81.1, −15.1], P &amp;lt; 0.001 and P1NP, −6.8 μg/L[−10.9, −2.7], P &amp;lt; 0.001. Testosterone significantly increased aBMD at the lumbar spine, 0.04 g/cm2 (0.03, 0.05), P &amp;lt; 0.001 and the total hip, 0.01 g/cm2 (0.01, 0.02), P &amp;lt; 0.001.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion</jats:title>\n                  <jats:p>In men ≥ 50 years of age, testosterone treatment for 2 years increased volumetric bone density, predominantly via effects on cortical bone. Implications for fracture risk reduction require further study.</jats:p>\n               </jats:sec>","journal":"The Journal of Clinical Endocrinology &amp; Metabolism","year":2021,"id":646351,"datarank":0.6394019815561974,"base_score":4.2626798770413155,"endowment":4.2626798770413155,"self_citation_contribution":0.6394019815561974,"citation_network_contribution":0.0,"self_endowment_contribution":0.6394019815561974,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":70,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1641973,"name":"Rudolf Hoermann","orcid":null,"position":1,"is_corresponding":false},{"id":1683455,"name":"Karen Bracken","orcid":null,"position":2,"is_corresponding":false},{"id":377053,"name":"David J. Handelsman","orcid":"0000-0002-4200-7476","position":3,"is_corresponding":false},{"id":1683456,"name":"Warrick J Inder","orcid":null,"position":4,"is_corresponding":false},{"id":1683457,"name":"Bronwyn G A Stuckey","orcid":null,"position":5,"is_corresponding":false},{"id":1683458,"name":"Bu B Yeap","orcid":null,"position":6,"is_corresponding":false},{"id":1683459,"name":"Ali Ghasem-Zadeh","orcid":null,"position":7,"is_corresponding":false},{"id":1683460,"name":"Kristy P Robledo","orcid":null,"position":8,"is_corresponding":false},{"id":1683461,"name":"David Jesudason","orcid":null,"position":9,"is_corresponding":false},{"id":143648,"name":"Jeffrey D Zajac","orcid":null,"position":10,"is_corresponding":false},{"id":426321,"name":"Gary Wittert","orcid":"0000-0001-6818-6065","position":11,"is_corresponding":false},{"id":849440,"name":"Mathis Grossmann","orcid":"0000-0001-8261-3457","position":12,"is_corresponding":false},{"id":1683454,"name":"Mark Ng Tang Fui","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-08-09T12:46:35.897091Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}