A Matched Retrospective Analysis: The Relationship Between Testosterone Replacement Therapy and the Incidence of Hip Fractures.

TRT use was associated with a decreased incidence of hip fractures compared with the control group.

• Hip fracture incidence was 0.13% in the TRT group versus 0.25% in the control group (P < 0.001).
• Multivariable logistic regression yielded an adjusted odds ratio (aOR) of 0.58 (95% CI, 0.51 to 0.66, P < 0.001).
• Patients prescribed TRT had a 1.9 times lower likelihood of sustaining hip fractures.
• Follow-up period was 2 years, and TRT use required a minimum duration of 3 months.

TRT use in male patients was associated with a decreased incidence of hip fractures on sex-stratified multivariable analysis.

• The adjusted odds ratio for hip fracture in male TRT users was 0.61 (95% CI, 0.53 to 0.72, P < 0.001).
• This finding was derived from sex-stratified subgroup analysis within the matched cohort.

TRT use in female patients was associated with a decreased incidence of hip fractures on sex-stratified multivariable analysis.

• The adjusted odds ratio for hip fracture in female TRT users was 0.49 (95% CI, 0.38 to 0.63, P < 0.001).
• The point estimate for females (aOR 0.49) suggested a stronger protective association than for males (aOR 0.61).

The study used one-to-one matched cohorts from the PearlDiver Mariner165 database totaling 301,724 patients.

• Two random cohorts of 500,000 patients each were obtained from the PearlDiver Mariner165 data set.
• The experimental group received TRT for at least 3 months; the control group did not receive TRT.
• One-to-one matching was applied, resulting in 301,724 patients evaluated.
• Hip fracture incidence was assessed using International Classification of Disease codes over a 2-year follow-up.
• Statistical significance was set at P < 0.05, and multivariable logistic regression was used to identify associations.