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A concise review of testosterone and bone health

Authors Mohamad NV, Soelaiman IN, Chin KY

Received 21 June 2016

Accepted for publication 29 July 2016

Published 22 September 2016 Volume 2016:11 Pages 1317—1324

DOI https://doi.org/10.2147/CIA.S115472

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 2

Editor who approved publication: Dr Richard Walker

Nur-Vaizura Mohamad, Ima-Nirwana Soelaiman, Kok-Yong Chin

Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lampur, Malaysia

Abstract: Osteoporosis is a condition causing significant morbidity and mortality in the elderly population worldwide. Age-related testosterone deficiency is the most important factor of bone loss in elderly men. Androgen can influence bone health by binding to androgen receptors directly or to estrogen receptors (ERs) indirectly via aromatization to estrogen. This review summarized the direct and indirect effects of androgens on bone derived from in vitro, in vivo, and human studies. Cellular studies showed that androgen stimulated the proliferation of preosteoblasts and differentiation of osteoblasts. The converted estrogen suppressed osteoclast formation and resorption activity by blocking the receptor activator of nuclear factor κ-B ligand pathway. In animal studies, activation of androgen and ERα, but not ERβ, was shown to be important in acquisition and maintenance of bone mass. Human epidemiological studies demonstrated a significant relationship between estrogen and testosterone in bone mineral density and fracture risk, but the relative significance between the two remained debatable. Human experimental studies showed that estrogen was needed in suppressing bone resorption, but both androgen and estrogen were indispensable for bone formation. As a conclusion, maintaining optimal level of androgen is essential in preventing osteoporosis and its complications in elderly men.

Keywords: androgen, men, osteopenia, osteoporosis, estrogen, skeleton

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