Evidence map›Paper›PMID 33693907›Full record

Trial reportThe Journal of clinical endocrinology and metabolism2021

Effect of Testosterone Treatment on Bone Microarchitecture and Bone Mineral Density in Men: A 2-Year RCT.

Mark Ng Tang Fui, Rudolf Hoermann, Karen Bracken, David J Handelsman, Warrick J Inder, Bronwyn G A Stuckey, Bu B Yeap, Ali Ghasem-Zadeh, Kristy P Robledo, David Jesudason and 3 more

Erratum issuedAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The Journal of clinical endocrinology and metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 33 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
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  19. Testosterone Replacement Therapy Is Associated With Increased Incidence Rate of Vertebral Fractures: A Matched Retrospective Analysis.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2025
    Article
  20. [Testosterone-"Fuel" for old men?]Innere Medizin (Heidelberg, Germany) · 2025
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors.

Mark Ng Tang FuiDepartment of Medicine (Austin Health), The University of Melbourne, Victoria, 3084, Australia.
Rudolf HoermannDepartment of Medicine (Austin Health), The University of Melbourne, Victoria, 3084, Australia.
Karen BrackenNHMRC Clinical Trials Centre, University of Sydney, New South Wales, 2050, Australia.
David J HandelsmanANZAC Research Institute, University of Sydney and Department of Andrology, Concord Hospital, Sydney New South Wales, 2139, Australia.ORCID 0000-0002-4200-7476
Warrick J InderPrincess Alexandra Hospital and the University of Queensland, Queensland, 4102, Australia.
Bronwyn G A StuckeyKeogh Institute for Medical Research, Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital and University of Western Australia, Western Australia, 6009, Australia.
Bu B YeapMedical School, University of Western Australia and Department of Endocrinology and Diabetes, Freemantle & Fiona Stanley Hospital, Perth, Western Australia, 6150, Australia.
Ali Ghasem-ZadehDepartment of Medicine (Austin Health), The University of Melbourne, Victoria, 3084, Australia.
Kristy P RobledoNHMRC Clinical Trials Centre, University of Sydney, New South Wales, 2050, Australia.
David JesudasonFreemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, South Australia, Australia, and The Queen Elizabeth Hospital, South Australia, 5000, Australia.
Jeffrey D ZajacDepartment of Medicine (Austin Health), The University of Melbourne, Victoria, 3084, Australia.
Gary A WittertFreemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, South Australia, Australia, and The Queen Elizabeth Hospital, South Australia, 5000, Australia.ORCID 0000-0001-6818-6065
Mathis GrossmannDepartment of Medicine (Austin Health), The University of Melbourne, Victoria, 3084, Australia.ORCID 0000-0001-8261-3457

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextTestosterone treatment increases bone mineral density (BMD) in hypogonadal men. Effects on bone microarchitecture, a determinant of fracture risk, are unknown.

objectiveWe aimed to determine the effect of testosterone treatment on bone microarchitecture using high resolution-peripheral quantitative computed tomography (HR-pQCT).

methodsMen ≥ 50 years of age were recruited from 6 Australian centers and were randomized to receive injectable testosterone undecanoate or placebo over 2 years on the background of a community-based lifestyle program. The primary endpoint was cortical volumetric BMD (vBMD) at the distal tibia, measured using HR-pQCT in 177 men (1 center). Secondary endpoints included other HR-pQCT parameters and bone remodeling markers. Areal BMD (aBMD) was measured by dual-energy x-ray absorptiometry (DXA) in 601 men (5 centers). Using a linear mixed model for repeated measures, the mean adjusted differences (95% CI) at 12 and 24 months between groups are reported as treatment effect.

resultsOver 24 months, testosterone treatment, versus placebo, increased tibial cortical vBMD, 9.33 mg hydroxyapatite (HA)/cm3) (3.96, 14.71), P < 0.001 or 3.1% (1.2, 5.0); radial cortical vBMD, 8.96 mg HA/cm3 (3.30, 14.62), P = 0.005 or 2.9% (1.0, 4.9); total tibial vBMD, 4.16 mg HA/cm3 (2.14, 6.19), P < 0.001 or 1.3% (0.6, 1.9); and total radial vBMD, 4.42 mg HA/cm3 (1.67, 7.16), P = 0.002 or 1.8% (0.4, 2.0). Testosterone also significantly increased cortical area and thickness at both sites. Effects on trabecular architecture were minor. Testosterone reduced bone remodeling markers CTX, -48.1 ng/L [-81.1, -15.1], P < 0.001 and P1NP, -6.8 μg/L[-10.9, -2.7], P < 0.001. Testosterone significantly increased aBMD at the lumbar spine, 0.04 g/cm2 (0.03, 0.05), P < 0.001 and the total hip, 0.01 g/cm2 (0.01, 0.02), P < 0.001.

conclusionIn men ≥ 50 years of age, testosterone treatment for 2 years increased volumetric bone density, predominantly via effects on cortical bone. Implications for fracture risk reduction require further study.

Indexed as

Absorptiometry, PhotonAgedBone DensityBone RemodelingCortical BoneDouble-Blind MethodHumansLumbar VertebraeMaleMiddle AgedTestosteroneTibiaTestosteronebonemicroarchitectureT4DMtestosterone

Identifiers

PMID33693907

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.