Relationship between sex steroid hormones and bone mineral density in male patients with type 2 diabetes mellitus

Abstract

Objective To investigate the correlation between serum levels of sex steroid hormones and bone mineral density (BMD) in men with type 2 diabetes mellitus (T2DM).Methods The study is a retrospective analysis.A total of 673 men with T2DM were enrolled.BMDs of lumbar spine 2-4 (L2-4),femoral neck (FN),and total hip (TH) were measured by dual-energy X-ray absorptiometry.Serum HbA1c,follicle-stimulating hormone (FSH),luteinizing hormone (LH),prolactin,estradiol,testosterone,free testosterone (FT),and sex hormone binding globulin (SHBG) levels were tested simultaneously.Results Pearson's correlation analysis revealed that FSH was negatively correlated with FN (r=-0.122,P=0.005) and TH (r=-0.109,P=0.012),and LH was also negatively correlated with FN (r=-0.086,P =0.048).However,all these negative relationships were lost after the adjustment of age and body mass index (BMI).Estradiol had a significantly positive correlation with L2-4 (r =0.114,P =0.011) and TH (r =0.091,P =0.043) BMD,and this relationship was not influenced by age,but disappeared after adjustment for BMI.Testosterone showed a weakly positive correlation with L2-4BMD,which still remained even after adjustment for BMI.There was no correlation of FT and prolactin with BMD.SHBG showed significantly negative correlations with three BMDs.Partial correlation analysis showed that the relationship remained significant even after adjusting for age,but disappeared after the adjustment for BMI.Multiple stepwise regression analysis revealed that SHBG,estradiol,and testosterone were the main factors that influenced the change of BMDs in men with T2DM.Conclusions Serum concentrations of sex steroid hormones and SHBG were correlated with the variation of BMDs in male patients with T2DM,and the subjects with higher SHBG concentrations were more likely to have low BMD. Key words: Diabetes mellitus, type 2 ; Men ; Bone mineral density; Sex hormones