Measure sex hormones in men

The measurement of oestradiol and testosterone, as well as sex hormone binding globulin SHBG levels in older men may help identify those at high risk of fracture, new research suggests. Published in Clinical Endocrinology & Metabolism, the study of nearly 1,500 men aged 65 years or older found that men with low levels of oestradiol or high levels of sex hormone binding globulin (SHBG) had an increased risk of non vertebral fracture. Oestradiol and SHBG levels were most predictive of fracture risk, and men with the combination of low oestradiol, low testosterone and high SHBG levels were at a more than three times higher risk for fracture than men with average levels. The researchers say their results cannot be considered proof of independent molecular effects of bioavailable sex steroids and SHBG, but they are consistent with the hypothesis. Although oestradiol and SHBG levels are not commonly measured when assessing skeletal health or fracture risk in men, our results suggest revision of these practices, the researchers said. “Our results suggest that bioavailable sex steroid and SHBG measurements may be useful in the clinical assessment of fracture risk in older men, and that the physiological implications of hypogonadism shoukd be considered in light of possible interactions among sex steroids and SHBG,” they concluded. Clinical Endocrinology & Metabolism 2009; published online ahead of print....