Correlation of poor bone health with serum testosterone levels in males with acquired immunodeficiency syndrome wasting syndrome

Objectives: Acquired immunodeficiency syndrome (AIDS) Wasting Syndrome, marked by unintentional weight loss and muscle wasting, is a common complication in individuals with human immunodeficiency virus (HIV). Hypogonadism – characterized by low serum testosterone – is frequently observed in this population and may contribute to poor bone health. This study aimed to examine the relationship between serum testosterone levels and bone mineral density (BMD) in males with AIDS Wasting Syndrome. Material and Methods: A cross-sectional observational study was conducted over 6 months at Guru Gobind Singh Medical College and Hospital, Faridkot, involving 60 HIV-positive male patients aged 18–50 years who met Centers for Disease Control and Prevention criteria for AIDS Wasting Syndrome. Patients with other causes of weight loss or hormonal abnormalities were excluded. Early morning serum total testosterone was measured using a chemiluminescence assay, and BMD at the calcaneus was assessed through quantitative ultrasonography. Based on T-scores, participants were categorized into normal BMD, osteopenia, or osteoporosis groups. Results: Out of 60 patients, 55 (91.7%) had low serum testosterone levels, and among them, 92.7% exhibited abnormal BMD. Of the five patients with normal testosterone, 60% also had reduced BMD. A statistically significant correlation was found between low testosterone levels and decreased BMD ( P = 0.0195). The lowest mean testosterone and CD4 counts were observed in patients with osteoporosis, suggesting more advanced disease and greater bone loss. Conclusion: This study found a strong correlation between low serum testosterone and poor bone health in males with AIDS Wasting Syndrome. Testosterone deficiency may serve as an early predictor of low BMD, highlighting the importance of hormonal screening and timely intervention in this high-risk group.