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Bone Density Screening and Re-screening in Postmenopausal Women and Older Men

  • Epidemiology and Pathophysiology (J Cauley and B Dawson-Hughes, Section Editors)
  • Published:
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Abstract

Clinical practice guidelines universally recommend bone mineral density (BMD) screening to identify osteoporosis in women aged 65 years and older. Risk assessment is recommended to guide BMD screening in postmenopausal women under age 65. Insufficient data are available to inform standard ages to start and stop BMD screening in postmenopausal women. Based on longitudinal studies of incident osteoporosis and fracture in postmenopausal women, an initial BMD test should be ordered for all women aged 65, and the frequency of re-screening should be based on age and BMD T score (more frequent testing for older age and lower T score). Although clinical practice guidelines recommend BMD screening according to risk factors for fracture in postmenopausal women under age 65, no standard approach to risk assessment exists. Minimal evidence is available to guide osteoporosis screening in men, but some experts recommend initiation of BMD screening in men at age 70.

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References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. Sackett D, Straus S, Richardson W, Rosenberg W, Haynes R. Diagnosis and screening. Evidence-based medicine: how to practice and teach EBM. 2nd ed. New York: Harcourt; 2000. p. 261.

  2. Gourlay ML, Preisser JS, Lui LY, Cauley JA, Ensrud KE. BMD screening in older women: initial measurement and testing interval. J Bone Mineral Res Off J Am Soc Bone Mineral Res. 2012;27(4):743–6. doi:10.1002/jbmr.1585.

    Article  Google Scholar 

  3. Burge R, Dawson-Hughes B, Solomon D, Wong J, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007;22:465–75.

    Article  PubMed  Google Scholar 

  4. Mackey DC, Black DM, Bauer DC, McCloskey EV, Eastell R, Mesenbrink P, et al. Effects of antiresorptive treatment on nonvertebral fracture outcomes. J Bone Miner Res. 2011;26(10):2411–8. doi:10.1002/jbmr.446.

    Article  CAS  PubMed  Google Scholar 

  5. Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2005;16 Suppl 2:S3-7. doi:10.1007/s00198-004-1702-6

  6. Sanchez-Riera L, Wilson N, Kamalaraj N, Nolla JM, Kok C, Li Y, et al. Osteoporosis and fragility fractures. Best Pract Res Clin Rheumatol. 2010;24(6):793–810. doi:10.1016/j.berh.2010.10.003.

    Article  PubMed  Google Scholar 

  7. Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ. 1996;312:1254–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Wainwright SA, Marshall LM, Ensrud KE, Cauley JA, Black DM, Hillier TA, et al. Hip fracture in women without osteoporosis. J Clin Endocrinol Metab. 2005;90(5):2787–93. doi:10.1210/jc.2004-1568.

    Article  CAS  PubMed  Google Scholar 

  9. Stone K, Seeley D, Lui L, Cauley J, Ensrud K, Browner W, et al. BMD at multiple sites and risk of fracture of multiple types: long-term results from the Study of Osteoporotic Fractures. J Bone Miner Res. 2003;18:1947–54.

    Article  PubMed  Google Scholar 

  10. Kanis JA, Oden A, Johansson H, Borgstrom F, Strom O, McCloskey E. FRAX and its applications to clinical practice. Bone. 2009;44(5):734–43. doi:10.1016/j.bone.2009.01.373.

    Article  PubMed  Google Scholar 

  11. Ensrud KE. Epidemiology of fracture risk with advancing age. J Gerontol A Biol Sci Med Sci. 2013;68(10):1236–42. doi:10.1093/gerona/glt092.

    Article  PubMed  Google Scholar 

  12. Wilks DC, Winwood K, Gilliver SF, Kwiet A, Chatfield M, Michaelis I, et al. Bone mass and geometry of the tibia and the radius of master sprinters, middle and long distance runners, race-walkers and sedentary control participants: a pQCT study. Bone. 2009;45(1):91–7. doi:10.1016/j.bone.2009.03.660.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Wells GA, Cranney A, Peterson J, Boucher M, Shea B, Robinson V, et al. Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev. 2008;1:CD001155. doi:10.1002/14651858.CD001155.pub2.

    PubMed  Google Scholar 

  14. Wells G, Cranney A, Peterson J, Boucher M, Shea B, Robinson V, et al. Risedronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev. 2008;1:CD004523.

    PubMed  Google Scholar 

  15. Lyles KW, Colon-Emeric CS, Magaziner JS, Adachi JD, Pieper CF, Mautalen C, et al. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007;357(18):1799–809. doi:10.1056/NEJMoa074941.

    Article  CAS  PubMed  Google Scholar 

  16. Ettinger B, Black DM, Mitlak BH, Knickerbocker RK, Nickelsen T, Genant HK, et al. Reduction of vertebral fracture risk in postmenopausal women with osteoporosis treated with raloxifene: results from a 3-year randomized clinical trial. Multiple Outcomes of Raloxifene Evaluation (MORE) Investigators. JAMA. 1999;282(7):637–45.

    Article  CAS  PubMed  Google Scholar 

  17. Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster JY, et al. Effect of parathyroid hormone (1-34) on fractures and bone mineral density in postmenopausal women with osteoporosis. N Engl J Med. 2001;344(19):1434–41. doi:10.1056/NEJM200105103441904.

    Article  CAS  PubMed  Google Scholar 

  18. Cummings SR, San Martin J, McClung MR, Siris ES, Eastell R, Reid IR, et al. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med. 2009;361(8):756–65. doi:10.1056/NEJMoa0809493.

    Article  CAS  PubMed  Google Scholar 

  19. Hernlund E, Svedbom A, Ivergard M, Compston J, Cooper C, Stenmark J, et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos. 2013;8(1-2):136. doi:10.1007/s11657-013-0136-1.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Watts NB, Leslie WD, Foldes AJ, Miller PD. 2013 International Society for Clinical Densitometry Position Development Conference: Task Force on Normative Databases. J Clin Densitometry Off J Int Soc Clin Densitometry. 2013;16(4):472–81. doi:10.1016/j.jocd.2013.08.001.

    Article  Google Scholar 

  21. Richy F, Gourlay ML, Garrett J, Hanson L, Reginster JY. Osteoporosis prevalence in men varies by the normative reference. J Clin Densitom. 2004;7(2):127–33.

    Article  PubMed  Google Scholar 

  22. Kanis JA, McCloskey E, Johansson H, Oden A, Leslie WD. FRAX((R)) with and without bone mineral density. Calcif Tissue Int. 2012;90(1):1–13. doi:10.1007/s00223-011-9544-7.

    Article  CAS  PubMed  Google Scholar 

  23. Siris ES, Adler R, Bilezikian J, Bolognese M, Dawson-Hughes B, Favus MJ et al. The clinical diagnosis of osteoporosis: a position statement from the National Bone Health Alliance Working Group. Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2014;25(5):1439-43. doi:10.1007/s00198-014-2655-z.

  24. Schousboe JT, Ensrud KE. Diagnostic criteria for osteoporosis should not be expanded. Lancet Diabetes Endocrinol. 2015;3(4):236–8. doi:10.1016/S2213-8587(15)00050-9.

    Article  PubMed  Google Scholar 

  25. Screening for osteoporosis in postmenopausal women: recommendations and rationale. Annals of internal medicine. 2002;137(6):526-8.

  26. Screening for osteoporosis: U.S. preventive services task force recommendation statement. Ann Intern Med. 2011;154(5):356-64. Doi: 10.1059/0003-4819-154-5-201103010-00307.

  27. Crandall CJ, Larson J, Gourlay ML, Donaldson MG, Lacroix A, Cauley JA, et al. Osteoporosis screening in postmenopausal women 50-64 years-old: comparison of U.S. Preventive Services Task Force Strategy and two traditional strategies in the Women's Health Initiative. J Bone Mineral Res Off J Am Soc Bone Mineral Res. 2014. doi:10.1002/jbmr.2174.

    Google Scholar 

  28. Crandall CJ, Larson JC, Watts NB, Gourlay ML, Donaldson MG, LaCroix A, et al. Comparison of fracture risk prediction by the US Preventive Services Task Force strategy and two alternative strategies in women 50-64 years old in the Women's Health Initiative. J Clin Endocrinol Metab. 2014;99(12):4514–22. doi:10.1210/jc.2014-2332.

    Article  CAS  PubMed  Google Scholar 

  29. Looker AC, Melton 3rd LJ, Borrud LG, Shepherd JA. Lumbar spine bone mineral density in US adults: demographic patterns and relationship with femur neck skeletal status. Osteoporos Int. 2012;23(4):1351–60. doi:10.1007/s00198-011-1693-z.

    Article  CAS  PubMed  Google Scholar 

  30. Looker AC, Frenk SM. Percentage of adults aged 65 and over with osteoporosis or low bone mass at the femur neck or lumbar spine: United States, 2005–2010. National Center for Health Statistics. August 2015. Available from: http://www.cdc.gov/nchs/data/hestat/osteoporsis/osteoporosis2005_2010.htm

  31. Johnell O, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, et al. Predictive value of BMD for hip and other fractures. J Bone Miner Res. 2005;20(7):1185–94. doi:10.1359/JBMR.050304.

    Article  PubMed  Google Scholar 

  32. Kanis JA, Oden A, Johnell O, Jonsson B, de Laet C, Dawson A. The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int. 2001;12(5):417–27. doi:10.1007/s001980170112.

    Article  CAS  PubMed  Google Scholar 

  33. Nelson H, Helfand M, Woolf S, Allan J. Screening for postmenopausal osteoporosis: a review of the evidence for the US Preventive Services Task Force. Ann Intern Med. 2002;137:529–41.

    Article  PubMed  Google Scholar 

  34. Wells G, Cranney A, Peterson J, Boucher M, Shea B, Robinson V, et al. Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database Syst Rev. 2008;1:CD001155.

    PubMed  Google Scholar 

  35. Fleurence RL, Iglesias CP, Johnson JM. The cost effectiveness of bisphosphonates for the prevention and treatment of osteoporosis: a structured review of the literature. Pharmacoeconomics. 2007;25(11):913–33.

    Article  CAS  PubMed  Google Scholar 

  36. Zaidi M, Turner CH, Canalis E, Pacifici R, Sun L, Iqbal J, et al. Bone loss or lost bone: rationale and recommendations for the diagnosis and treatment of early postmenopausal bone loss. Curr Osteoporos Rep. 2009;7(4):118–26.

    Article  PubMed  Google Scholar 

  37. Castelo-Branco C, Davila J, Perello MF, Peguero A, Ros C, Martinez-Serrano MJ, et al. Long-term effect of hormone therapy on bone in early menopause: vertebral fractures after 20 years. Climacteric. 2014;17(4):336–41. doi:10.3109/13697137.2013.871511.

    Article  CAS  PubMed  Google Scholar 

  38. Ravn P, Weiss SR, Rodriguez-Portales JA, McClung MR, Wasnich RD, Gilchrist NL, et al. Alendronate in early postmenopausal women: effects on bone mass during long-term treatment and after withdrawal. Alendronate Osteoporosis Prevention Study Group. J Clin Endocrinol Metab. 2000;85(4):1492–7. doi:10.1210/jcem.85.4.6549.

    CAS  PubMed  Google Scholar 

  39. Ravn P, Bidstrup M, Wasnich RD, Davis JW, McClung MR, Balske A, et al. Alendronate and estrogen-progestin in the long-term prevention of bone loss: four-year results from the early postmenopausal intervention cohort study. A randomized, controlled trial. Ann Intern Med. 1999;131(12):935–42.

    Article  CAS  PubMed  Google Scholar 

  40. Cummings SR. A 55-year-old woman with osteopenia. JAMA. 2006;296(21):2601–10. doi:10.1001/jama.296.21.2601.

    Article  CAS  PubMed  Google Scholar 

  41. Woo SB, Hellstein JW, Kalmar JR. Narrative [corrected] review: bisphosphonates and osteonecrosis of the jaws. Ann Intern Med. 2006;144(10):753–61.

    Article  CAS  PubMed  Google Scholar 

  42. Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, et al. Oral bisphosphonate-induced osteonecrosis: risk factors, prediction of risk using serum CTX testing, prevention, and treatment. J Oral Maxillofac Surg. 2008;66(6):1320–1. doi:10.1016/j.joms.2008.01.054. author reply 1-2.

    Article  PubMed  Google Scholar 

  43. Odvina CV, Levy S, Rao S, Zerwekh JE, Rao DS. Unusual mid-shaft fractures during long-term bisphosphonate therapy. Clin Endocrinol (Oxford). 2010;72(2):161–8. doi:10.1111/j.1365-2265.2009.03581.x.

    Article  CAS  Google Scholar 

  44. Odvina CV, Zerwekh JE, Rao DS, Maalouf N, Gottschalk FA, Pak CY. Severely suppressed bone turnover: a potential complication of alendronate therapy. J Clin Endocrinol Metab. 2005;90(3):1294–301. doi:10.1210/jc.2004-0952.

    Article  CAS  PubMed  Google Scholar 

  45. Banks E, Reeves GK, Beral V, Balkwill A, Liu B, Roddam A. Hip fracture incidence in relation to age, menopausal status, and age at menopause: prospective analysis. PLoS Med. 2009;6(11):e1000181. doi:10.1371/journal.pmed.1000181.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Runhaar J, Schiphof D, van Meer B, Reijman M, Bierma-Zeinstra SM, Oei EH. How to define subregional osteoarthritis progression using semi-quantitative MRI Osteoarthritis Knee Score (MOAKS). Osteoarthr Cartil. 2014;22(10):1533–6. doi:10.1016/j.joca.2014.06.022.

    Article  CAS  PubMed  Google Scholar 

  47. Baim S, Binkley N, Bilezikian J, Kendler D, Hans D, Lewiecki E, et al. Official Positions of the International Society for Clinical Densitometry and Executive Summary of the 2007 ISCD Position Development Conference. J Clin Densitom. 2008;11:75–91.

    Article  PubMed  Google Scholar 

  48. Nelson H, Haney E, Dana T, Bougatsos C, Chou R. Screening for osteoporosis: an update for the U.S. Preventive Services Task Force. Ann Intern Med. 2010;153:1–13.

    Article  Google Scholar 

  49. Schousboe JT, Gourlay ML. Comparative effectiveness and cost-effectiveness of strategies to screen for osteoporosis in postmenopausal women. Ann Intern Med. 2011;155(11):788–9. doi:10.1059/0003-4819-155-11-201112060-00012.

    Article  PubMed  Google Scholar 

  50. Gourlay ML, Overman RA, Fine JP, Ensrud KE, Crandall CJ, Gass ML, et al. Baseline age and time to major fracture in younger postmenopausal women. Menopause. 2014. doi:10.1097/GME.0000000000000356.

    Google Scholar 

  51. Overman RA, Farley JF, Curtis JR, Zhang J, Gourlay ML, Deal CL. DXA utilization between 2006 and 2012 in commercially insured younger postmenopausal women. J Clin Densitometry Off J Int Soc Clin Densitometry. 2015;18(2):145–9. doi:10.1016/j.jocd.2015.01.005.

    Article  Google Scholar 

  52. Zhang J, Delzell E, Zhao H, Laster AJ, Saag KG, Kilgore ML, et al. Central DXA utilization shifts from office-based to hospital-based settings among medicare beneficiaries in the wake of reimbursement changes. J Bone Mineral Res Off J Am Soc Bone Mineral Res. 2012;27(4):858–64. doi:10.1002/jbmr.1534.

    Article  Google Scholar 

  53. Bonnick S, Johnston CJ, Kleerekoper M, Lindsay R, Miller P, Sherwood L, et al. Importance of precision in bone density measurements. J Clin Densitom. 2001;4:105–10.

    Article  CAS  PubMed  Google Scholar 

  54. Hillier T, Stone K, Bauer D, Rizzo J, Pedula K, Cauley J, et al. Evaluating the value of repeat bone mineral density measurement and prediction of fractures in older women. Arch Intern Med. 2007;167:155–60.

    Article  PubMed  Google Scholar 

  55. Frost S, Nguyen N, Center J, Eisman J, Nguyen T. Timing of repeat BMD measurements: development of an absolute risk-based prognostic model. J Bone Miner Res. 2009;24:1800–7.

    Article  PubMed  Google Scholar 

  56. Gourlay ML, Fine JP, Preisser JS, May RC, Li C, Lui LY, et al. Bone-density testing interval and transition to osteoporosis in older women. N Engl J Med. 2012;366(3):225–33. doi:10.1056/NEJMoa1107142. This competing risk analysis estimated the time to incident osteoporosis by BMD criteria for women aged 67 and older followed for up to 15 years in the Study of Osteoporotic Fractures. The time for 10% of women with baseline T-scores > -1.50 to transition to osteoporosis was approximately 17 years. The corresponding time intervals for women with baseline T-scores -1.50 to -1.99 and -2.00 to -2.49 were 5 years and 1 year respectively.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  57. Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, et al. Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures Fracture Intervention Trial Research Group. Lancet. 1996;348(9041):1535–41.

    Article  CAS  PubMed  Google Scholar 

  58. McClung MR, Geusens P, Miller PD, Zippel H, Bensen WG, Roux C, et al. Effect of risedronate on the risk of hip fracture in elderly women. Hip Intervention Program Study Group. N Engl J Med. 2001;344(5):333–40. doi:10.1056/NEJM200102013440503.

    Article  CAS  PubMed  Google Scholar 

  59. Cranney A, Guyatt G, Griffith L, Wells G, Tugwell P, Rosen C. Meta-analyses of therapies for postmenopausal osteoporosis. IX: Summary of meta-analyses of therapies for postmenopausal osteoporosis. Endocr Rev. 2002;23(4):570–8.

    Article  CAS  PubMed  Google Scholar 

  60. Schott A, Ganne C, Hans D, Monnier G, Gauchoux R, Krieg M, et al. Which screening strategy using BMD measurements would be most cost effective for hip fracture prevention in elderly women? A decision analysis based on a Markov model. Osteoporos Int. 2007;18:143–51.

    Article  CAS  PubMed  Google Scholar 

  61. De Laet CE, Van Hout BA, Burger H, Weel AE, Hofman A, Pols HA. Hip fracture prediction in elderly men and women: validation in the Rotterdam study. J Bone Miner Res. 1998;13(10):1587–93. doi:10.1359/jbmr.1998.13.10.1587.

    Article  PubMed  Google Scholar 

  62. Cummings SR, Cawthon PM, Ensrud KE, Cauley JA, Fink HA, Orwoll ES. BMD and risk of hip and nonvertebral fractures in older men: a prospective study and comparison with older women. J Bone Miner Res. 2006;21(10):1550–6. doi:10.1359/jbmr.060708.

    Article  PubMed  Google Scholar 

  63. Berger C, Langsetmo L, Joseph L, Hanley DA, Davison KS, Josse R, et al. Change in bone mineral density as a function of age in women and men and association with the use of antiresorptive agents. CMAJ. 2008;178(13):1660–8. doi:10.1503/cmaj.071416.

    Article  PubMed Central  PubMed  Google Scholar 

  64. Bass E, French DD, Bradham DD, Rubenstein LZ. Risk-adjusted mortality rates of elderly veterans with hip fractures. Ann Epidemiol. 2007;17(7):514–9. doi:10.1016/j.annepidem.2006.12.004.

    Article  PubMed  Google Scholar 

  65. von Friesendorff M, McGuigan FE, Besjakov J, Akesson K. Hip fracture in men-survival and subsequent fractures: a cohort study with 22-year follow-up. J Am Geriatr Soc. 2011;59(5):806–13. doi:10.1111/j.1532-5415.2011.03399.x.

    Article  Google Scholar 

  66. Haentjens P, Magaziner J, Colon-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, et al. Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med. 2010;152(6):380–90. doi:10.1059/0003-4819-152-6-201003160-00008.

    Article  PubMed Central  PubMed  Google Scholar 

  67. Morin S, Lix LM, Azimaee M, Metge C, Caetano P, Leslie WD. Mortality rates after incident non-traumatic fractures in older men and women. Osteoporos Int. 2011;22(9):2439–48. doi:10.1007/s00198-010-1480-2.

    Article  CAS  PubMed  Google Scholar 

  68. Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2009;301(5):513–21. doi:10.1001/jama.2009.50.

    Article  CAS  PubMed  Google Scholar 

  69. Robbins JA, Biggs ML, Cauley J. Adjusted mortality after hip fracture: From the cardiovascular health study. J Am Geriatr Soc. 2006;54(12):1885–91. doi:10.1111/j.1532-5415.2006.00985.x.

    Article  PubMed  Google Scholar 

  70. Forsen L, Sogaard AJ, Meyer HE, Edna T, Kopjar B. Survival after hip fracture: short- and long-term excess mortality according to age and gender. Osteoporos Int. 1999;10(1):73–8.

    Article  CAS  PubMed  Google Scholar 

  71. Jacobsen SJ, Goldberg J, Miles TP, Brody JA, Stiers W, Rimm AA. Race and sex differences in mortality following fracture of the hip. Am J Public Health. 1992;82(8):1147–50.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  72. Orwoll E, Ettinger M, Weiss S, Miller P, Kendler D, Graham J, et al. Alendronate for the treatment of osteoporosis in men. N Engl J Med. 2000;343(9):604–10. doi:10.1056/NEJM200008313430902.

    Article  CAS  PubMed  Google Scholar 

  73. Ringe JD, Faber H, Dorst A. Alendronate treatment of established primary osteoporosis in men: results of a 2-year prospective study. J Clin Endocrinol Metab. 2001;86(11):5252–5.

    Article  CAS  PubMed  Google Scholar 

  74. Ringe JD, Dorst A, Faber H, Ibach K. Alendronate treatment of established primary osteoporosis in men: 3-year results of a prospective, comparative, two-arm study. Rheumatol Int. 2004;24(2):110–3. doi:10.1007/s00296-003-0388-y.

    Article  CAS  PubMed  Google Scholar 

  75. Sawka AM, Papaioannou A, Adachi JD, Gafni A, Hanley DA, Thabane L. Does alendronate reduce the risk of fracture in men? A meta-analysis incorporating prior knowledge of anti-fracture efficacy in women. BMC Musculoskelet Disord. 2005;6:39. doi:10.1186/1471-2474-6-39.

    Article  PubMed Central  PubMed  Google Scholar 

  76. Ringe JD, Farahmand P, Faber H, Dorst A. Sustained efficacy of risedronate in men with primary and secondary osteoporosis: results of a 2-year study. Rheumatol Int. 2009;29(3):311–5. doi:10.1007/s00296-008-0689-2.

    Article  CAS  PubMed  Google Scholar 

  77. Ringe JD, Faber H, Farahmand P, Dorst A. Efficacy of risedronate in men with primary and secondary osteoporosis: results of a 1-year study. Rheumatol Int. 2006;26(5):427–31. doi:10.1007/s00296-005-0004-4.

    Article  CAS  PubMed  Google Scholar 

  78. Boonen S, Orwoll ES, Wenderoth D, Stoner KJ, Eusebio R, Delmas PD. Once-weekly risedronate in men with osteoporosis: results of a 2-year, placebo-controlled, double-blind, multicenter study. J Bone Miner Res. 2009;24(4):719–25. doi:10.1359/jbmr.081214.

    Article  CAS  PubMed  Google Scholar 

  79. Boonen S, Reginster JY, Kaufman JM, Lippuner K, Zanchetta J, Langdahl B, et al. Fracture risk and zoledronic acid therapy in men with osteoporosis. N Engl J Med. 2012;367(18):1714–23. doi:10.1056/NEJMoa1204061. This randomized clinical trial demonstrated significant reduction of radiographic vertebral fracture in older men with osteoporosis treated with zoledronic acid. This was the first clinical trial of men that used fracture as the primary endpoint.

    Article  CAS  PubMed  Google Scholar 

  80. Ensrud KE, Taylor BC, Peters KW, Gourlay ML, Donaldson MG, Leslie WD, et al. Implications of expanding indications for drug treatment to prevent fracture in older men in United States: cross sectional and longitudinal analysis of prospective cohort study. BMJ. 2014;349:g4120. doi:10.1136/bmj.g4120. This observational study demonstrated that different choices of the definition of osteoporosis in men had major effects on the proportion of men identified as candidates for antifracture treatment. The prevalence of hip and major osteoporotic fracture by each definition suggested that men with osteoporosis by WHO diagnostic criteria are most likely to benefit from treatment.

    Article  PubMed Central  PubMed  Google Scholar 

  81. Lewiecki E, Gordon C, Baim S, Leonard M, Bishop N, Bianchi M, et al. International Society for Clinical Densitometry 2007 adult and pediatric official positions. Bone. 2008;43:1115–21.

    Article  PubMed  Google Scholar 

  82. Liu H, Paige NM, Goldzweig CL, Wong E, Zhou A, Suttorp MJ, et al. Screening for osteoporosis in men: a systematic review for an American College of Physicians guideline. Ann Intern Med. 2008;148(9):685–701.

    Article  PubMed  Google Scholar 

  83. Qaseem A, Snow V, Shekelle P, Hopkins Jr R, Forciea MA, Owens DK. Screening for osteoporosis in men: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2008;148(9):680–4.

    Article  PubMed  Google Scholar 

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Acknowledgments

We acknowledge Anne Looker PhD and Steven M. Frenk for providing data in NCHS Health E-Stat that was important for our discussion of osteoporosis in men.

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Authors and Affiliations

  1. Department of Family Medicine, University of North Carolina, Aycock Building; Manning Drive, CB #7595, Chapel Hill, NC, 27599-7595, USA

    Margaret L. Gourlay

  2. Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina, Kerr Hall, Room 2304, North Carolina, Chapel Hill, NC, 27599-7573, USA

    Robert A. Overman

  3. Department of Medicine and Division of Epidemiology, General Internal Medicine (111-0), University of Minnesota, Minneapolis, MN, 55417, USA

    Kristine E. Ensrud

  4. Department of Medicine, VA Medical Center, One Veterans Drive, Minneapolis, MN, USA

    Kristine E. Ensrud

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  1. Margaret L. Gourlay
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Correspondence to Margaret L. Gourlay.

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Dr. Gourlay is supported by Grant Number R01 AG046294 from the National Institute on Aging. The content is solely the responsibility of the authors and does not necessarily reflect the official views of the funding agency.

Dr. Overman and Dr. Ensrud have nothing to disclose.

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Gourlay, M.L., Overman, R.A. & Ensrud, K.E. Bone Density Screening and Re-screening in Postmenopausal Women and Older Men. Curr Osteoporos Rep 13, 390–398 (2015). https://doi.org/10.1007/s11914-015-0289-5

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  • DOI: https://doi.org/10.1007/s11914-015-0289-5

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