Testosterone deficiency raises risk 1.9 times

Vitamin D deficiency raises risk 1.6 times

From left: Professor Bae Woong-jin of the urology department at Seoul St. Mary's Hospital and Professor Lee Dong-seop of the urology department at St. Vincent's Hospital. [Seoul St. Mary's Hospital]
From left: Professor Bae Woong-jin of the urology department at Seoul St. Mary's Hospital and Professor Lee Dong-seop of the urology department at St. Vincent's Hospital. [Seoul St. Mary's Hospital]

Older men with low testosterone and vitamin D levels face a significantly higher risk of reduced hip bone density, a new study has found.

A research team led by Professor Bae Woong-jin of the urology department at Catholic University of Korea Seoul St. Mary's Hospital — with Professor Lee Dong-seop of St. Vincent's Hospital's urology department as corresponding author — analyzed data from 557 men aged 60 and older who underwent health checkups at Seoul St. Mary's Hospital and St. Vincent's Hospital between January 2020 and December 2024. The team announced the findings Friday.

Bone density in the lumbar spine and hip was measured using dual-energy X-ray absorptiometry, the standard method for bone density assessment. Blood testosterone and vitamin D levels were measured via liquid chromatography-tandem mass spectrometry.

The analysis found that the factors affecting bone density differed by body site. Lumbar spine bone density was influenced by body mass index and testosterone levels, while hip bone density was affected by age, BMI, testosterone and vitamin D combined.

Men with testosterone deficiency — defined as levels below 3.5 ng/mL — had about 1.9 times the risk of low hip bone density compared with those in the normal range. Men with vitamin D deficiency, defined as levels below 30 ng/mL, faced about 1.6 times the risk. Among men with low testosterone, changes in hip bone density based on vitamin D levels were more pronounced than in the normal-testosterone group.

The research team said that when vitamin D levels drop in men who already have low testosterone, calcium absorption efficiency declines, which can accelerate bone loss.

Related research indicates that osteopenia affects about 50 percent of men aged 60 and older, yet only 7 percent of patients diagnosed with testosterone deficiency actually undergo bone density testing.

"It is important for middle-aged and older men to check their testosterone and vitamin D levels together and manage them proactively," Bae said. "I recommend not dismissing symptoms of male menopause — such as fatigue, muscle weakness and decreased sexual function — and instead getting regular hormone and bone density tests through a urologist."

"Hip fractures and similar injuries can pose a serious threat to the health and quality of life of older patients, so a multifaceted approach is needed rather than simply attributing them to aging," Lee said. "I hope these findings can serve as clinical guidelines that provide real, practical help to more patients."

The study was conducted as part of a research project supported by the Korean Urological Association, examining the effects of testosterone replacement therapy and vitamin D treatment on bone metabolism in male menopause.


woo@heraldcorp.com