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Observational Study
. 2022 Aug 5:13:939897.
doi: 10.3389/fendo.2022.939897. eCollection 2022.

FSH and bone: Comparison between males with central versus primary hypogonadism

Luca Giovanelli  1   2   3 , Richard Quinton  3   4 , Biagio Cangiano  1   2 , Stefano Colombo  1 , Luca Persani  1   2 , Marco Bonomi  1   2 , Iacopo Chiodini  1   2
Affiliations
Observational Study

FSH and bone: Comparison between males with central versus primary hypogonadism

Luca Giovanelli et al. Front Endocrinol (Lausanne). .

Abstract

Objective: Experimental studies proposed a direct effect of follicle-stimulating hormone (FSH) on the skeletal metabolism, but results of human studies mainly conducted in females are controversial. The present study aims to investigate the possible role of FSH excess in male bone health, by comparing for the first time primary and central hypogonadism.

Design and methods: 119 men were enrolled in this cross-sectional observational study at the time of the first diagnosis of hypogonadism. All participants had spontaneous pubertal development. Regarding patients with hypergonadotropic hypogonadism (Hyper-H), Klinefelter syndrome (KS) patients were distinguished from the other forms (non-KS-Hyper-H) based on the onset of FSH elevation. Bone mineral density (BMD) at both lumbar spine (LS) and femoral neck (FN), as well as the prevalence of morphometric vertebral fractures (VFx), were assessed.

Results: Across the whole cohort, higher LS and FN BMD were associated with older age at diagnosis and higher body mass index (BMI), respectively. After adjusting for potential confounders (age at diagnosis, BMI, smoking habits, degree of hypogonadism defined by calculated free testosterone, and 25OH vitamin D levels), non-KS-Hyper-H patients showed significantly lower LS BMD and tended to show lower FN BMD values, as compared to those with hypogonadotropic hypogonadism (Hypo-H). In KS men, LS BMD was significantly lower than in those with non-KS-Hyper-H. No significant differences in the prevalence of VFx were found between the groups.

Conclusions: These findings suggest a potential negative effect of FSH excess on the male bone mass, especially at spine. The duration of high FSH levels may also contribute to these findings.

Keywords: bone metabolism; follicle-stimulating hormone; hypergonadotropic; hypogonadotropic; male hypogonadism; male osteoporosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart used for selecting participants. PPO-Hypo-Hypo, pre-pubertal onset hypogonadotropic hypogonadism; cfT, calculated free testosterone.
Figure 2
Figure 2
Association between LS BMD and age at diagnosis. LS BMD, lumbar spine bone mineral density.
Figure 3
Figure 3
Association between FN BMD and BMI. FN BMD, femoral neck bone mineral density; BMI, body mass index.
See this image and copyright information in PMC

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