Serum Osteocalcin Levels Correlate with Hypogonadal Symptoms in Men: Implications for the Use of Osteocalcin as a Marker for Hypogonadism
American Urological Association conference
Abstract: 806
Date & Time: May 21, 2012 08:00 AM
Session Title: Sexual Function/Dysfunction/Andrology: Basic Research I
Sources of Funding: None
Introduction and Objectives
Osteocalcin is secreted by osteoblasts and is a marker of bone formation. In addition, recent work implicates osteocalcin as a regulator of testosterone (T) production through its stimulation of Leydig cells, potentially implicating osteocalcin in hypogonadism. The diagnosis of hypogonadism currently relies on evaluation of serum T and free T levels, as well as hypogonadal symptoms. However, the role of osteocalcin as a possible marker for hypogonadism is unclear. Here we evaluate the association between serum osteocalcin levels and the symptoms of hypogonadism.
Methods
A review of 54 men presenting to our clinic was performed, and demographic information, testosterone (T) and osteocalcin levels were obtained for each patient. All patients completed the quantitative Androgen Decline in the Aging Male (qADAM) questionnaire, a metric for the evaluation of hypogonadal symptoms, and responses were correlated to osteocalcin levels using Spearman’s rank correlation.
Results
Mean±SD subject age was 51.1±11.6 years, serum T 398.4±190.2 ng/dL, and osteocalcin 5.35±3.33 ng/mL. Significant negative correlations were observed between osteocalcin and total qADAM score (ρ=-0.422, p=0.002), as well as individual qADAM questions including energy level (ρ=-0.304, p=0.025), strength endurance rating (ρ=-0.349, p=0.01), enjoyment of life (ρ=-0.299 p=0.028) and happiness (ρ=-0.391, p=0.004) ratings, and work performance over the last 4 weeks (ρ=-0.319, p=0.019). We then separated men by total qADAM score into 0-20 (severe hypogonadism), 21-30 (moderate hypogonadism), and >30 (minimal or no hypogonadism) and observed a significant difference between osteocalcin levels in the 0-20 (mean±SD osteocalcin 6.3±3.5 ng/mL) and >30 groups (osteocalcin 2.2±1.8 ng/mL, p=0.03). No significant differences in serum testosterone were observed in any subgroup, and no impact on qADAM score or osteocalcin level was observed as a function of whether men were on testosterone replacement therapy.
Conclusions
Serum osteocalcin levels are inversely correlated with hypogonadal symptoms assessed using the qADAM questionnaire, suggesting that osteocalcin may be a useful marker for hypogonadism. Future work to further validate these conclusions, in the form of more extensive evaluation of the interplay of serum and symptomatic parameters, as well as concomitant evaluation of bone health, will further elucidate the utility of osteocalcin as a serum marker for hypogonadism.
Authors
Pastuszak, Alexander W. (Houston, TX); Badhiwala, Niraj; Song, Weitao; Lamb, Dolores J.; Lipshultz, Larry I.; Khera, Mohit
