Evidence map›Paper›PMID 41032457›Full record

SynthesisThe Journal of clinical endocrinology and metabolism2025

Incomplete Evidence of Bone Density Normalization Following Long-Term Reproductive Hormone Treatment in Men With Hypogonadotropic Hypogonadism.

Nipun Lakshitha de Silva, Elizabeth Hyams, Bonnie Grant, Paras Dixit, Rajdeep Bassi, Paul Bassett, Alexander N Comninos, Channa N Jayasena

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nipun Lakshitha de SilvaSection of Investigative Medicine, Imperial College London, Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK.ORCID 0000-0002-4467-3659
Elizabeth HyamsSection of Investigative Medicine, Imperial College London, Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK.
Bonnie GrantSection of Investigative Medicine, Imperial College London, Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK.ORCID 0000-0003-1121-9211
Paras DixitSection of Investigative Medicine, Imperial College London, Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK.
Rajdeep BassiSection of Investigative Medicine, Imperial College London, Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK.
Paul BassettStatsconsultancy Ltd, Amersham, Bucks HP7 9EN, UK.
Alexander N ComninosSection of Investigative Medicine, Imperial College London, Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK.ORCID 0000-0002-7104-2297
Channa N JayasenaSection of Investigative Medicine, Imperial College London, Commonwealth Building, Hammersmith Hospital, London W12 0NN, UK.ORCID 0000-0002-2578-8223

Funding

MRCNHSNIHR
6 · The paper itself

Abstract

contextThe prevalence and severity of low bone mineral density (BMD) in hypogonadotropic hypogonadism (HH), as well as the ability of reproductive hormone treatment to normalize BMD have not been investigated in large multicenter studies.

objectiveWe performed a systemic review and meta-analysis of several small, observational studies to investigate the effect of reproductive hormone treatment on BMD in men with HH compared with control groups where available.

methodsWe searched OVID Medline, Embase, CINAHL, SCOPUS, Web of Science, and Cochrane Library for studies reporting BMD or fractures in men with HH (congenital [CHH] or acquired). Study selection and data extraction were performed using COVIDENCE and a prespecified tool. Results were summarized using descriptive statistics. Meta-analysis compared BMD in men with HH vs healthy controls. Meta-regression assessed relationships between treatment duration and BMD Z-scores against normative population data.

resultsOf the 33 eligible studies, 24 included data specific to men with HH (n = 625). Men with HH had low lumbar spine (LS) and femoral neck BMD, improving with hormonal treatment. Meta-analysis of 5 studies found lower LS BMD in men with HH vs healthy controls (SMD -5.98; 95% CI; -11.5 to -0.47). Men with CHH may have persistently low BMD despite prolonged hormonal treatment. Higher BMD in HH was associated with younger age at treatment initiation, partial HH, and higher serum testosterone and estradiol concentrations. Fracture prevalence was high in the few studies systematically studying fractures as an outcome; in other studies, fractures were seldom reported.

conclusionMen with HH have low BMD that improves with reproductive hormone treatment. However, current evidence suggests that incomplete BMD normalization may be common despite long-term reproductive hormone treatment in men with HH, particularly those with CHH.

Indexed as

Bone DensityHormone Replacement TherapyHypogonadismAdultHumansMaleTestosteroneTestosteronebone mineral densityfractureshypogonadotropic hypogonadismKallmann syndromemetabolic bone diseaseosteoporosis

Identifiers

PMID41032457
PMCPMC12712975

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Registered trials

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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.