Osteoporosis in a boy with hypogonadotropic hypogonadism

  • Madoka Arisaka
  • Osamu Arisaka
  • Atsuto Hosaka
  • Akifumi Tokita
  • Naoto Shimura
  • Keijiro Yabuta
  • Yoshindo Kawaguchi
Original Articles


We describe a 16-year-old boy with idiopathic hypogonadotropic hypogonadism associated with osteoporosis. Osteoporotic lesions of the hands, skull and spine were shown by routine radiography. Single-photon absorptiometry at the distal radius confirmed a significant reduction of bone mineral density. The parathyroid hormone-vitamin D axis and calcitonin secretion showed no derangement. Reduced bone mineral density in association with relatively elevated levels of serum osteocalcin and alkaline phosphatase suggested an increased bone turnover (so-called high-turnover osteoporosis). Tetosterone therapy for 3 months significantly increased the radial bone mineral density.

This case illustrates that testosterone deficiency during puberty seems to alter the bone mineral status, impairing bone mineralization and bone remodeling.


Bone Mineral Density Osteoporosis Testosterone Bone Mineral Content Hypogonadism 


  1. 1.
    Riggs B.L. and Melton L.J. III: Involutional osteoporosis. N. Engl. J. Med. 314, 1676–1686, 1986.PubMedGoogle Scholar
  2. 2.
    Johnston Jr. C.C., Hui S.L., Witt R.M., et al: Early menopausal changes in bone mass and sex steroids. J. Clin. Endocrinol. Metab. 61, 905–911, 1985.PubMedGoogle Scholar
  3. 3.
    Drinkwater B.L., Nilson K., Chesnut III C.H., st al: Bone mineral content of amenorrheic and eumenorrheic athletes. N. Engl. J. Med. 311, 277–81, 1984.PubMedGoogle Scholar
  4. 4.
    Seeman E., Melton L.J. III, O'Fallon W.M., et al: Risk factors for spinal osteoporosis in men. Am. J. Med. 75, 977–983, 1983.PubMedCrossRefGoogle Scholar
  5. 5.
    DiGeorge AM. Hypogonadotropic hypogonadism in the male. In: Nelson Textbook of Pediatrics, 13th edition, (Behrman R.E. and Vaughan V.C. III eds.), WB Saunders Company, Philadelphia, pp. 1234–1235, 1987.Google Scholar
  6. 6.
    Johanson J.S., Giwercman A., Hartwell D., et al: Serum bone Gla-protein as a marker of bone growth in children and adolescents: Correlation with age, height, serum insulin-like growth factor I, and serum testosterone. J. Clin. Endocrinol. Metab. 67, 273–278, 1988.Google Scholar
  7. 7.
    Yamamoto H., Arai T., Masuda K., et al: Serum osteocalcin during growth in children. Igakunoayumi 139, 1045–1046, 1986. (English abstr.)Google Scholar
  8. 8.
    Arisaka O., Arisaka M., Shimizu T., et al: Primary hyperparathyroidism. Clin. Pediatr. 24, 347–50, 1985.CrossRefGoogle Scholar
  9. 9.
    Aurbach G.D., Marx S.J. and Spiegel A.M.: Control of bone formation and resorption. In: William's Textbook of Endocrinology, 7th edition, (Wilson J.D. and Foster D.W. eds.), WB Saunders Company, Philadelphia, pp. 1223–1226, 1985.Google Scholar
  10. 10.
    Shore R.M., Chesney R.W., Mazess R., et al: Bone mineral status in growth hormone deficiency. J. Pediatr. 96, 393–396, 1980.PubMedCrossRefGoogle Scholar
  11. 11.
    Krabbe S., Transbol I. and Christiansen C.: Bone mineral homeostasis, bone growth, and mineralization dring years of pubertal growth; a unifying concept. Arch. Dis. Chid. 57, 359–363, 1982.Google Scholar
  12. 12.
    Aloia J.F., Vaswani A.N., Yeh J.K., et al.: Premenopausal bone mass is related to physical activity. Arch. Inter. Med. 148, 121–123, 1988.CrossRefGoogle Scholar
  13. 13.
    Rigotti, N.A., Nussbaum S.R., Herzog D.B., et al.: Osteoporosis in women with anorexia nervosa. N. Engl. J. Med. 311, 1601–1606, 1984.PubMedGoogle Scholar
  14. 14.
    Foresta C., Ruzza R., Guarneri G.. et al.: Testosterone and bone loss in Klinefelter syndrome. Horm. Metabol. Res. 15, 56–57, 1983.Google Scholar
  15. 15.
    Ruzza C.F., Mioni R., Guarneri G., et al.: Osteoporosis and decline of gonadal function in the elderly male. Hormone Res. 19, 18–22, 1984.PubMedCrossRefGoogle Scholar
  16. 16.
    Greenspan S.L., Neer R.M., Ridgway E.C., et al.: Osteoporosis in men with hyperprolactinemic hypogonadism. Ann. Inter. Med. 104, 777–782, 1986.Google Scholar
  17. 17.
    Finkelstein J.S., Klibaski A., Neer M., et al: Osteoporosis in men with idiopathic hypogonadotropic hypogonadism. Ann. Inter. Med. 106, 354–361, 1987.Google Scholar
  18. 18.
    Arisaka O., Arisaka M., Hosaka A., et al: Bone mineral status in hypopituitarism. Am. J. Dis. Child. 143, 272–273, 1989.PubMedGoogle Scholar
  19. 19.
    Arisaka O., Arisaka M., Hosaka A., et al: Increase in bone density during testosterone therapy in adolescent hypogonadism. Eur. J. Pediatr. 148, 579, 1989.PubMedCrossRefGoogle Scholar
  20. 20.
    Gilsanz V., Gibbens D.T., Roe T.F., et al: Vertebral bone density in children: Effect of puberty. Radiology 166, 847–850, 1988.PubMedGoogle Scholar
  21. 21.
    Chesney R.W. and Shore R.M.: The noninvasive determination of bone mineral content by photon acsorptiometry. Am. J. Dis. Child. 136, 578–580, 1982.PubMedGoogle Scholar
  22. 22.
    Krabbe S., Hummer L. and Christiansen C.: Longitudinal study of calcium metabolism in male puberty. II Relationship between mineralization and serum testosterone. Acta. Paediatr. Scand. 73, 578–580, 1982.Google Scholar
  23. 23.
    Francis R.M., Peacock M., Aaron J.F., et al: Osteoporosis in hypogonadal men: role of decreased plasma 1,25-dihydroxyvitamin D, calcium malabsorption, and low bone fromation. Bone 7, 261–268, 1986.PubMedCrossRefGoogle Scholar
  24. 24.
    Finkelstein J., Klibanski A., Neer M., et al: Increases in bone density during treatment of men with idiopathic hypogonadotropic hypogonadism. Clin. Res. 36, 384, 1988. (abstr.)Google Scholar
  25. 25.
    Brown J.P., Delmas P.D., Malaval L., et al: Serum bone GLA-protein: A specific marker for bone formation in postmenopausal osteoporosis. Lancet i, 1091–1092, 1984.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Bone Metabolism Research 1989

Authors and Affiliations

  • Madoka Arisaka
    • 1
  • Osamu Arisaka
    • 1
  • Atsuto Hosaka
    • 1
  • Akifumi Tokita
    • 1
  • Naoto Shimura
    • 1
  • Keijiro Yabuta
    • 1
  • Yoshindo Kawaguchi
    • 2
  1. 1.Department of Pediatrics, JuntendoUniversity School of MedicineTokyoJapan
  2. 2.The Second Division, Department of Internal MedicineThe Jikei University School of MedicineTokyo

Personalised recommendations