(213) TESTOSTERONE SUPPLEMENTATION AND BONE PARAMETERS: A SYSTEMATIC REVIEW AND META-ANALYSIS STUDY.

Objectives: The role of testosterone (T) replacement therapy (TRT) in subjects with late onset hypogonadism is still the object of an intense debate. Methods: All observational studies and placebo-controlled or -uncontrolled randomized trials (RCTs) comparing the effect of TRT on different bone parameters were considered. Results: Out of 349 articles, 36 were considered, including 3103 individuals with a mean trial duration of 66.6 weeks. TRT improves areal bone mineral density (aBMD) at the spine and femoral neck levels in observational studies, whereas placebo-controlled RTCs showed a positive efect of TRT only at lumber spine and when trials included only hypogonadal patients at baseline (total testosterone<12 nM). The effects on aBMD were more evident in subjects with lower T levels at baseline and increased as a function of trial duration and a higher prevalence of diabetic subjects. Either T or estradiol increase at endpoint contributed to aBMD improvement. TRT was associated with a signifcant reduction of bone resorption markers in observational but not in controlled studies. Conclusions: TRT is able to inhibit bone resorption and increase bone mass, particularly at the lumbar spine level and when the duration is long enough to allow the anabolic efect of T and estrogens on bone metabolism to take place. Conflicts of Interest: The authors declare no confict of interest. [ABSTRACT FROM AUTHOR]