This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Attention to osteoporosis has largely emphasized women's health, and little attention has focused on the diagnosis and prevention of osteoporotic fractures in men. And yet the disease is also an important problem in men. Testosterone levels decline with advancing age, and severe testosterone deficiency is associated with low bone mass and fracture. Several epidemiologic studies suggest that low testosterone is associated with low bone mass in older men, but this finding is not consistent. Men with hip fracture are found to be testosterone deficient more often than control subjects. Among men over age 70 with testosterone levels below the young normal range, we found differences in bioavailable testosterone accounted for 20% of the variance in femoral neck bone mineral density (FN BMD) values. Additional predictors of FN BMD in this population incuded body mass index and physical activity, two described parameters of frailty. Based on these data, testosterone supplementation may be important for bone health and frailty in older men. We will test the hypothesis that testosterone supplementation can increase bone mineral density in older men with hip fracture. We will also evaluate the effects of testosterone on physical health and frailty.
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