Relationship of sex steroid hormones with bone mineral density (BMD) in a nationally representative sample of men

Channing J. Paller, Meredith S. Shiels, Sabine Rohrmann, Shehzad Basaria, Nader Rifai, William Nelson, Elizabeth A. Platz, Adrian Dobs

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Objective: Sex steroid hormones influence bone mineral density (BMD) in women, but are less well-studied in men. We evaluated the association of serum total and free sex steroid hormones and SHBG with osteopaenia in a nationally representative sample of men aged 20-90 years. Design: BMD and sex steroid hormones were measured among participants in NHANES III, a cross-sectional study of the US population. Population: A total of 1185 adult men in morning examination session of Phase I of NHANES III (1988-91). Measurements: Relation of oestradiol (E2), testosterone, and SHBG concentrations with BMD. Osteopaenia was defined as 1-2.5 SD below the mean for white men aged 20-29 years. Results: Men in the lowest quartile of free E2 had 70% increased odds (OR = 1.69, 95% CI 0.95-2.98) of osteopaenia compared with men in the highest quartile. Men in the lowest quartile of free testosterone had nearly four times the odds of osteopaenia than those in the highest quartile (OR = 3.82, 95% CI 1.87-7.78). Lower concentrations of SHBG appeared protective against osteopaenia (P-trend = 0.01). Neither total testosterone nor total E2 was associated with BMD, although men with clinically low E 2 (< 20 ng/l) had lower BMD (0.930 g/cm2, 95% CI 0.88-0.98) than men with normal-range E2 (1.024 g/cm2, 95% CI 1.01-1.04; P = 0.004). Findings for free E2 were most pronounced among elderly men, while the findings for free testosterone were most pronounced among younger men. Conclusions: In this nationally representative study, men with lower free E2, lower free testosterone, and higher SHBG concentrations in circulation were more likely to have low BMD.

Original languageEnglish (US)
Pages (from-to)26-34
Number of pages9
JournalClinical Endocrinology
Issue number1
StatePublished - Jan 2009

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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