E2 and Testosterone Protect Against Bone Marrow Fat & Osteoporosis

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Higher bone marrow fat (BMF) is associated with osteoporosis and reduced hematopoiesis. Exogenous estradiol reduces BMF in older women, but effects of endogenous sex hormones are unknown.

  • 244 men and 226 women, mean age 81.5 (SD 4.1) years, all residents of Iceland were enrolled in this study.
  • Vertebral BMF was measured with magnetic resonance spectroscopy. Estradiol, testosterone and sex hormone binding globulin were measured on archived serum.
  • Mean BMF was 54.1% (SD 8.6) (men) and 54.7% (SD 8.1) (women).
  • In adjusted models, per 1pg/ml increase in total estradiol, there was a statistically significant 0.26% decrease in BMF in men (95% CI: -0.41, -0.11) and a non-significant 0.20% decrease in women (95% CI: -0.55, 0.15), with no evidence of interaction by gender.
  • Per 10ng/dl increase in total testosterone, there was a significant 0.10% decrease in BMF in men (95% CI: -0.17, -0.03) and a non-significant 0.13% (95% CI: -0.79, 0.53) decrease in women, with no evidence of interaction by gender (p=0.97).

CONCLUSION:

Higher bone marrow fat is associated with lower total estradiol and testosterone levels in older men, with a similar but statistically non-significant association in older women. Sex hormone levels appear to play a role in the regulation of bone marrow fat in older adults.

"Sex hormones are negatively associated with vertebral bone marrow fat," Bone, 2017 December 11, https://www.ncbi.nlm.nih.gov/pubmed/29241825/
 
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