Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2008 Sep;19(9):1307-14.
doi: 10.1007/s00198-008-0573-7. Epub 2008 Mar 20.

Additive benefit of higher testosterone levels and vitamin D plus calcium supplementation in regard to fall risk reduction among older men and women

H A Bischoff-Ferrari  1 , E J Orav, B Dawson-Hughes
Affiliations
Randomized Controlled Trial

Additive benefit of higher testosterone levels and vitamin D plus calcium supplementation in regard to fall risk reduction among older men and women

H A Bischoff-Ferrari et al. Osteoporos Int. 2008 Sep.

Abstract

Higher physiologic testosterone levels among community dwelling older men and women may protect against falls, and this benefit may be further increased among those taking additional vitamin D plus calcium.

Introduction: The aim of this study is to investigate sex hormone levels and fall risk in older men and women.

Methods: One hundred and ninety-nine men and 246 women age 65+ living at home were followed for 3 years after baseline assessment of sex hormones. Analyses controlled for several covariates, including baseline 25-hydroxyvitamin D, sex hormone binding globulin, and vitamin D plus calcium treatment (vitD+cal).

Results: Compared to the lowest quartile, men and women in the highest quartile of total testosterone had a decreased odds of falling (men: OR = 0.22; 95% CI [0.07,0.72]/ women: OR = 0.34; 95% CI [0.14,0.83]); if those individuals also took vitD+cal, the fall reduction was enhanced (men: OR = 0.16; 95% CI [0.03,0.90] / women: OR = 0.15; 95% CI [0.04,0.57]). Similarly, women in the top quartile of dihydroepiandrosterone sulfate (DHEA-S) had a lower risk of falling (OR = 0.39; 95% CI [0.16,0.93]). Other sex hormones and SHBG did not predict falling in men or women.

Conclusions: Higher testosterone levels in both genders and higher DHEA-S levels in women predicted a more than 60% lower risk of falling. With vitD+cal, the anti-fall benefit of higher physiologic testosterone levels is enhanced from 78% to 84% among men and from 66% to 85% among women.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Odds of falling by quartile of total testosterone in men and in women
Independent of age, body mass index, physical activity, SHBG levels, 25(OH)D levels, vitamin D plus calcium treatment, number of comorbid conditions, smoking and alcohol consumption, there was a significant trend in men (test for trend: p = 0.005) and women (test for trend: p = 0.03) suggesting a decrease in the odds of falling with higher testosterone levels. Comparing the two extreme quartiles, men in the highest quartile had a 78% and women had a 66% lower odds of falling. Results were similar with or without adjustment for SHBG.
Figure 2
Figure 2. Adjusted mean baseline leg and total body lean mass by quartiles of baseline SHBG
Mean adjusted lean mass by quartiles of SHBG is adjusted for age, physical activity, 25(OH)D levels, number of comorbid conditions, smoking and alcohol consumption. P-values for comparison of quartiles with reference quartile (bottom quartile for SHBG): * < 0.05, ** < 0.001. Among men, the test for trend was significant for total body (p = 0.005) and leg (0.03) lean mass. Among women, the test for trend was significant among women for total body (p = 0.005) and leg (p = 0.0002) lean mass.
See this image and copyright information in PMC

References

    1. Amin S, Zhang Y, Felson DT, Sawin CT, Hannan MT, Wilson PW, Kiel DP. Estradiol, testosterone, and the risk for hip fractures in elderly men from the Framingham Study. Am J Med. 2006;119(5):426–33. - PubMed
    1. Fink HA, Ewing SK, Ensrud KE, Barrett-Connor E, Taylor BC, Cauley JA, Orwoll ES. Association of testosterone and estradiol deficiency with osteoporosis and rapid bone loss in older men. J Clin Endocrinol Metab. 2006;91(10):3908–15. Epub 2006 Jul 18. - PubMed
    1. Mellstrom D, Johnell O, Ljunggren O, Eriksson AL, Lorentzon M, Mallmin H, Holmberg A, Redlund-Johnell I, Orwoll E, Ohlsson C. Free testosterone is an independent predictor of BMD and prevalent fractures in elderly men: MrOS Sweden. J Bone Miner Res. 2006;21(4):529–35. Epub 2006 Apr 5. - PubMed
    1. Riggs BL, Khosla S, Melton LJ., 3rd Sex steroids and the construction and conservation of the adult skeleton. Endocr Rev. 2002;23(3):279–302. - PubMed
    1. Pfeilschifter J, Scheidt-Nave C, Leidig-Bruckner G, Woitge HW, Blum WF, Wuster C, Haack D, Ziegler R. Relationship between circulating insulin-like growth factor components and sex hormones in a population-based sample of 50-to 80-year-old men and women. J Clin Endocrinol Metab. 1996;81(7):2534–40. - PubMed

Publication types