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Testosterone concentrations in men on chronic glucocorticosteroid therapy
R C Fitzgerald1, S J Skingle, A J Crisp
1Addenbrooke's Hospital, Cambridge.
Journal of the Royal College of Physicians of London
|March 1, 1997
Summary
Glucocorticosteroids, like prednisolone, significantly lower free testosterone levels in men with chronic inflammatory diseases. This reduction in active testosterone may contribute to steroid-induced osteoporosis.
Area of Science:
- Endocrinology
- Pharmacology
- Rheumatology
Background:
- Glucocorticosteroids are widely used for chronic inflammatory diseases.
- Potential side effects include osteoporosis, but the mechanisms are not fully understood.
Purpose of the Study:
- To investigate the effect of glucocorticosteroids on free (active) testosterone concentrations in men.
- To explore the potential link between reduced testosterone and glucocorticosteroid-induced osteoporosis.
Main Methods:
- Serum testosterone and sex hormone-binding globulin (SHBG) were measured in 17 men on prednisolone and 13 controls.
- The testosterone/SHBG ratio, an indicator of free testosterone, was calculated.
Main Results:
- Patients receiving prednisolone showed a significantly reduced testosterone/SHBG ratio compared to controls (p = 0.026).
- This indicates that glucocorticosteroids decrease free (active) testosterone levels.
Conclusions:
- Glucocorticosteroid therapy reduces free testosterone in male patients.
- This hormonal change may be a key factor in the development of glucocorticosteroid-induced osteoporosis.
- Monitoring and potentially supplementing testosterone could be a novel approach for bone protection in these patients.