Association of Serum Estradiol and Testosterone With Hip Fractures in Elderly Men

INTRODUCTION: Hip fractures in the elderly are a major public health concern due to high morbidity, mortality, and long-term disability. While men have a lower incidence of hip fractures than women, the risk rises sharply with age, and outcomes in men are often worse. Sex steroids (especially estrogen and testosterone) play a crucial role in bone metabolism, but their contribution to osteoporosis and fracture risk in elderly men remains under-investigated, particularly in diverse populations. This prospective case-control study aimed to determine whether serum estradiol and testosterone levels differ significantly between elderly South Indian men with osteoporotic hip fractures and age-matched healthy controls. METHODS: A prospective case-control study was conducted on men over 55 years of age at a South Indian tertiary hospital (March-May 2022). Fifty men with osteoporotic hip fractures (cases) and 50 age-matched healthy male controls were recruited. Clinical data (age, body mass index, smoking status) were collected, and serum total estradiol and testosterone levels were measured using enzyme-linked fluorescent immunoassay. Overt androgen deficiency was defined as total testosterone