OSTEOPOROSIS IN MEN-A REVIEW (original) (raw)
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Osteoporosis in Men: A Review of an Underestimated Bone Condition
International Journal of Molecular Sciences, 2021
Osteoporosis is called the ‘silent disease’ because, although it does not give significant symptoms when it is not complicated, can cause fragility fractures, with serious consequences and death. Furthermore, the consequences of osteoporosis have been calculated to weigh heavily on the costs of health systems in all the countries. Osteoporosis is considered a female disease. Actually, the hormonal changes that occur after menopause certainly determine a significant increase in osteoporosis and the risk of fractures in women. However, while there is no doubt that women are more exposed to osteoporosis and fragility fractures, the literature clearly indicates that physicians tend to underestimate the osteoporosis in men. The review of the literature done by the authors shows that osteoporosis and fragility fractures have a high incidence also in men; and, furthermore, the risk of fatal complications in hip fractured men is higher than that for women. The authors report the evidence of...
Australian family physician, 2001
While strict criteria have been developed for defining osteoporosis in women (bone mineral density measurements more than 2.5 standard deviations below the mean for young adult normal women, i.e. t-score value < -2.5), there still remains a controversy regarding the definition in men. Spinal fractures occur in 5% and hip fractures in 6% of men older than 50 years. There are significant differences between men and women with respect to the pathogenesis of osteoporosis, underlying medical conditions and postfracture sequelae. To provide an overview of the pathogenesis, diagnosis and prevention of osteoporosis in men. Osteoporosis is increasingly recognised. Data from the Dubbo Osteoporosis Epidemiology Study suggests that 30% of men in Australia aged over 60 years will suffer from an osteoporotic fracture. It is estimated that 30-60% of men presenting with spinal fractures will have another illness contributing to their bone loss. Osteoporotic fractures in men are associated with h...
Osteoporosis in men: Pathophysiology and treatment
Current Sexual Health Reports, 2008
Osteoporosis has long been long considered a disease of the aging female skeleton. However, it is now clear that men are also at risk for this disorder. Epidemiologic studies have confirmed that osteoporotic fractures in men are an increasing public health problem, in part due to increased longevity and increased public awareness. Recent largescale population studies in men have led to advances in our understanding of bone fragility and its treatment in men. This article reviews what is known about the factors in men that lead to acquisition, maintenance, and loss of bone, as well as new insights into causes, pathogenesis, and treatment of osteoporosis in men.
Male osteoporosis: Diagnosis and fracture risk evaluation
Joint Bone Spine, 2009
Male osteoporosis is challenging to diagnose and to treat. Underestimation of the risk of male osteoporosis, the combined presence of several interwoven causative factors in many patients, and uncertainty regarding the absorptiometry cutoffs associated with fractures are major obstacles to the diagnosis of male osteoporosis and to the identification of men at risk for fractures. The lifetime risk of osteoporotic fracture is estimated at 15% among men older than 50 years. One-third of proximal femoral fractures occur in men, and the associated mortality rate is 2-to 3-fold that in women. In men, nearly half the cases of osteoporosis are related to disease, medications, or risk factors. Although the criteria for diagnosing male osteoporosis are not agreed on, the definitions developed by the World Health Organization can be used provided the reference population is composed of young males. An absorptiometry T-score À2.5 is useful for diagnosing osteoporosis but fails to adequately predict the fracture risk. The identification of men at high risk for fractures requires a combined evaluation of bone mineral density data, clinical risk factors, and risk factors for falls.
World Journal of Orthopedics, 2012
Osteoporosis in men is a heterogeneous disease that has received little attention. However, one third of worldwide hip fractures occur in the male population. This problem is more prevalent in people over 70 years of age. The etiology can be idiopathic or secondary to hypogonadism, vitamin D deficiency and inadequate calcium intake, hormonal treatments for prostate cancer, use of toxic and every disease or drug use that alters bone metabolism. Risk factors such as a previous history of fragility fracture should be assessed for the diagnosis. However, risk factors in men are very heterogeneous. There are significant differences in the pharmacological treatment of osteoporosis between men and women fundamentally due to the level of evidence in published trials supporting each treatment. New treatments will offer new therapeutic prospects. The goal of this work is a revision of the present status knowledge about male osteoporosis.
Osteoporosis in Men?Consensus is Premature
Calcified Tissue International, 2004
At this meeting an attempt was made to develop consensus statements on osteoporosis in men in the closing session. The session raised more questions than it resolved, and the following summarizes consensus views and defines areas in need of further research. Epidemiology 1. Osteoporosis is a public health problem in men because of the fragility fractures that occur. The remaining lifetime probability of fracture at the age of 50 years in men in Sweden is 4.6% for forearm fractures, 10.7% for hip fractures, 8.3% for clinical spine fractures, and 4.1% for fractures of the proximal humerus. The remaining lifetime probability any of these fractures is 22.4% in men from Sweden compared with a probability of 46.4% in women. The hospital bed days accounted for by osteoporotic fracture in men exceed those due to prostatic cancer. Life expectancy is increasing in both sexes, but at a greater rate with calendar year in men compared with women. 2. The age-specific pattern of fracture differs between sexes. At the ages of 50-54 years, the most common fractures in men occur in the ribs, spine, and forearm, respectively. In women the order of fracture sites is forearm, spine, ribs, and humerus. After the age of 50 years most fractures are approximately 2-3 times more common in women, but in both sexes the likelihood of fracture increases with aging. With advancing age hip fractures become more common and between 85 and 89 years comprise 33% of all osteoporotic fractures in men and 36% in women. 3. There is a greater than ten fold difference in the ageadjusted incidence of hip fractures between different countries. Whereas the risk in women varies markedly, it is also apparent that a similar variation, though less marked, occurs in men. In communities where the risk of hip fracture is high in women, the risk is also high in men. For example, the risk among men born in Seville, Spain, is higher than the risk in women from Turkey. The greater variation between countries than between sexes within countries indicates that variations in menopause cannot explain the differences between communities. 4. Register studies suggest that international variations also occur in the incidence of other osteoporotic fractures. Where the risk of hip fracture is high, so too is the risk of forearm fractures. There is a close correlation between hip fracture admission in different countries and admission to hospital for vertebral fracture. This is observed in both sexes. Prospective studies of the incidence of vertebral fracture as judged by quantitative morphometry suggest that international variations in vertebral fracture are much less marked than for forearm or hip fractures. 5. The frequency of hip and some other osteoporotic fractures has increased, in part because of an increase in life expectancy. Life expectancy has increased in many countries at a rate higher for men than in women. Projections by the UN suggest that this increase will continue at least up to the year 2100. In most European countries the number of elderly will increase by 30%-70% between 1990 and 2025. 6. In the year 2000 there were estimated to be 424,000 hip fractures world wide in men. Based on the changing demographics there will be 800,000 hip
Osteoporosis in Men: New Insights into Aetiology, Pathogenesis, Prevention and Management
Drugs Aging, 1998
Osteoporosis is increasingly recognised in men. Low bone mass, risk factors for falling and factors causing fractures in women are likely to cause fractures in men. Bone mass is largely genetically determined, but environmental factors also contribute. Greater muscle strength and physical activity are associated with higher bone mass, while radial bone loss is greater in cigarette smokers or those with a moderate alcohol intake. Sex hormones have important effects on bone physiology. In men, there is no abrupt cessation of testicular function or 'andropause' comparable with the menopause in women; however, both total and free testosterone levels decline with age. A common secondary cause of osteoporosis in men is hypogonadism. There is increasing evidence that estrogens are important in skeletal maintenance in men as well as women. Peripheral aromatisation of androgens to estrogens occurs and osteoblast-like cells can aromatise androgens into estrogens. Human models exist for the effects of estrogens on the male skeleton. In men aged >65 years, there is a positive association between bone mineral density (BMD) and greater serum estradiol levels at all skeletal sites and a negative association between BMD and testosterone at some sites.
Management of Osteoporosis in Men: A Narrative Review
International Journal of Molecular Sciences
Male osteoporosis is a still largely underdiagnosed pathological condition. As a consequence, bone fragility in men remains undertreated mainly due to the low screening frequency and to controversies in the bone mineral density (BMD) testing standards. Up to the 40% of overall osteoporotic fractures affect men, in spite of the fact that women have a significant higher prevalence of osteoporosis. In addition, in males, hip fractures are associated with increased morbidity and mortality as compared to women. Importantly, male fractures occur about 10 years later in life than women, and, therefore, due to the advanced age, men may have more comorbidities and, consequently, their mortality is about twice the rate in women. Gender differences, which begin during puberty, lead to wider bones in males as compared with females. In men, follicle-stimulating hormones, testosterone, estrogens, and sex hormone-binding levels, together with genetic factors, interact in determining the peak of bo...