Journal of Endocrinological Investigation

, Volume 24, Issue 5, pp 326–333 | Cite as

Age-related changes in bone density among healthy Greek males

  • G. E. Krassas
  • F. G. Papadopoulou
  • D. Doukidis
  • Th. Konstantinidis
  • K. Kalothetou
Original Article
First Online:
Accepted:

Abstract

Osteoporosis in men is increasingly recognized as a problem in clinical medicine, but it has received much less attention than its counterpart in women. It is termed idiopathic if no known cause of bone disease can be identified clinically or in the laboratory. The true incidence of idiopathic osteoporosis (IO) in males is difficult to estimate because population characteristics and referral patterns differ so widely. The aim of this study was to investigate the incidence of IO in healthy Greek male volunteers by measuring bone mineral density (BMD) at four skeletal sites and examining the relations among age, BMI, and bone status. This type of information has not yet been published. We considered osteoporosis to be present when the BMD was less than or equal to −2.5 SD from the average value for healthy young men. Three hundred and sixty-three normal male volunteers were investigated. The mean age was 51.3±8.7 yr, and BMI was 27.5±3.7 kg/m2. In all subjects BMD at four skeletal sites — lumbar spine (LS), femoral neck (FN), Ward’s triangle (WT), and finally trochanter (T) — was measured using dual-energy X-ray absorptiometry (DEXA). T-score, Z-score and g/cm2 values were estimated. Forty-four subjects (11%) had BMD<—2.5 SD (T-score). The mean age and BMI for the men with decreased BMD was 54.8±6.4 yr and 26.3±3.3 kg/m2, whereas mean age and BMI for those with normal BMD was 51.0±8.9 yr and 27.6±3.6 kg/m2, respectively. These differences were statistically significant (p<0.001 and p<0.05, respectively). A positive correlation was found between BMI and bone density (g/cm2) at three skeletal sites: LS (r=0.235, p<0.001), WT (r=0.126, p<0.001) and FN (r=0.260, p<0.001). A positive correlation was also found between BMI and T-score at all skeletal sites studied: LS (r=0.276, p<0.001), WT (r=0.133, p<0.05), FN (r=0.233, p<0.001), and T (r=0.305, p<0.001). Finally, a positive correlation was also found between BMI and Z-score: LS (r=0.256, p<0.001), WT (r=0.117, p<0.005), FN (r=0.240, p<0.001), and T (r=0.187, p<0.001). A negative correlation was found between age and bone density (g/cm2) at FN (r=−0.157, p<0.01) and WT (r=−0.183, p<0.001). The same was true between age and T-score at FN only (r=0.137, p<0.05). Furthermore, a similar correlation was found between age and Z-score at LS (r=0.174, p<0.001). When ANOVA one-way analysis was used, a significant difference was found between the different age groups and BMD (g/cm2) at FN, T, and WT (p<0.001 for all sites). For T-score, a significant difference between age groups was found only at FN (p<0.005). Finally, a significant difference in Z-score was found at FN (p<0.001) and LS (p<0.005). When multiple regression analysis was applied, it was found that BMD (g/cm2) at two sites, FN and WT, independently correlated with age and BMI (FN: p<0.001 for both, WT: p<0.01 and p<0.05, respectively). Finally, we found an accelerated trend toward decreased BMD (g/cm2), when the odds ratio was applied. In conclusion, this study demonstrated that 11% of otherwise healthy Greek men had BMD less than or equal to −2.5 SD. A strong association was found between BMD (g/cm2) and age at three skeletal sites when ANOVA one-way analysis was applied. Moreover, BMD was positively correlated with BMI and negatively correlated with age. Currently available data are sparse and much more research is needed to increase our understanding concerning the etiology of this condition as well as illuminating the relationship between bone density and fracture.

Key-words

Male osteoporosis idiopathic osteoporosis in men bone mineral density dual-energy X-ray absorptiometry (DEXA) treatment of idiopathic osteoporosis 
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Orwoll E.S., Klein R.F. Osteoporosis in men. Endocr. Rev. 1995, 16: 87–115.PubMedCrossRefGoogle Scholar
  2. 2.
    Jackson J.A., Kleerekoper M. Osteoporosis in men: Diagnosis, pathophysiology and prevention. Medicine 1990, 69: 139–152.CrossRefGoogle Scholar
  3. 3.
    Seeman E., Melton L.J., O’ Fallon W.M., Riggs B.L. Risk factors for spinal osteoporosis in men. Am. J. Med. 1983, 75: 977–983.PubMedCrossRefGoogle Scholar
  4. 4.
    Francis R.M., Peacock M., Marshall D.H., Horsman A., Aaron J.E. Spinal osteoporosis in men. Bone Miner. 1989, 5: 347–357.PubMedCrossRefGoogle Scholar
  5. 5.
    Resch H., Pietschmann P., Woloszczuk W., Krexner E., Bernecher P., Willvonseder R. Bone mass and biochemical parameters of bone metabolism in men with spinal osteoporosis. Eur. J. Clin. Invest. 1992, 22: 542–545.PubMedCrossRefGoogle Scholar
  6. 6.
    Parfitt A.M., Duncan H. Metabolic bone disease affecting the spine. In: Roteman R. (Ed.), The spine, ed.2. W.B. Saunders, Philadelphia, 1982, p. 775.Google Scholar
  7. 7.
    De Vernejoul M.C., Bielakoff J., Herve M., Gueris J., Hott M., Modrowski D., Kuntz D., Miravet L.L., Ryckcwaert A. Evidence for defective osteoblastic function. A role for alcohol and tobacco consumption in osteoporosis in middle-aged men. Clin. Orthop. 1983, 179: 107–115.PubMedCrossRefGoogle Scholar
  8. 8.
    Hillis E., Dunstan C.R., Wong S.Y.P., Evans R.A. Bone histology in young adult osteoporosis. J. Clin. Pathol. 1989, 42: 391–327.CrossRefGoogle Scholar
  9. 9.
    Aaron J.E., Francis R.M., Peacock M., Nakins N.B. Contrasting microanatomy of idiopathic and corticosteroid-induced osteoporosis. Clin. Orthop. Rel. Res. 1989, 243: 294–305.Google Scholar
  10. 10.
    Melton L.J. III, Atkinson E.J., O’Falla W.M., Wahner H.W., Riggs B.L. Long term fracture prediction by bone mineral assessed at different skeletal sites. J. Bone Miner. Res. 1993, 8: 1227–1233.PubMedCrossRefGoogle Scholar
  11. 11.
    Cummings S.R., Blach C.K., Nevitt M.C., Browner W., Cauley J., Ensrud K., Genant H.K., Palermo L., Scott J., Vogt T.M. for the Study of Osteoporotic Fractures Research Group. Bone density at various sites for prediction of hip fractures. Lancet 1993, 341: 72–75.PubMedCrossRefGoogle Scholar
  12. 12.
    Flicker L., Green R., Kaymakci B., Buirski G., Wark J.D. Do Australian women have greater spinal bone density than North American women? Osteop. Inv. 1995, 5: 63–65.CrossRefGoogle Scholar
  13. 13.
    Daniels E.D., Pettifor J.M., Schnitzler C.M., Russell S.W., Pastel D.N. Ethnic differences in bone density in female South African nurses. J. Bone Miner. Res. 1995, 10: 359–367.PubMedCrossRefGoogle Scholar
  14. 14.
    Kanis J.L., Melton L.S., Christiansen C., Johnston C.C., Khaltaev N. The diagnosis of osteoporosis. J. Bone Miner. Res. 1994, 9: 1137–1141.PubMedCrossRefGoogle Scholar
  15. 15.
    World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Technical report series No. 843, WHO, Geneva, 1994.Google Scholar
  16. 16.
    Bilezikian J.P. Osteoporosis in men. J. Clin. Endocrinol. Metab. 1999, 84: 3431–3434.PubMedGoogle Scholar
  17. 17.
    Kanis J.A., Delmas P., Burckhardt P., Cooper C., Torgerson D. Guidelines for diagnosis and management of osteoporosis. Osteoporos. Int. 1997, 7: 390–406.PubMedCrossRefGoogle Scholar
  18. 18.
    Legrand E., Chappard D., Pascaretti C., Duquenne M., Rondeau C., Simon Y., Rohmer Y., Basle M.F., Audran M. Bone mineral density and vertebral fractures in men. Osteop. Inv. 1999, 10: 265–270.CrossRefGoogle Scholar
  19. 19.
    Jackson J.A., Kleerekoper M., Parfitt A.M., Rao D.S., Villanueva A.R., Frame B. Bone histomorphometry in hypogonadal and eugonadal men with spinal osteoporosis. J. Clin. Endocrinol. Metab. 1987, 65: 53–58.PubMedCrossRefGoogle Scholar
  20. 20.
    Riggs B.L., Wanner H.W., Seeman E., Offord K.P., Dunn W.L., Mazess R.B., Johnson K.A., Melton L.J. III. Changes in bone mineral density of the proximal femur and spine with aging. Differences between the postmenopausal and senile osteoporosis syndromes. J. Clin. Invest. 1982, 70: 716–723.PubMedCentralPubMedCrossRefGoogle Scholar
  21. 21.
    Aloia J.F., Vasmani A., Ellis K., Yven K., Cohn S.H. A model for involutional bone loss. J. Lab. Clin. Med. 1985, 106: 630–637.PubMedGoogle Scholar
  22. 22.
    Mazess R.B., Barden H.S., Drinke P.U., Dauwens S.F., Orwoll E.S., Bell N.H. Influence of age and body weight on spine and femur bone mineral density in US white men. J. Bone Miner. Res. 1990, 5: 645–652.PubMedCrossRefGoogle Scholar
  23. 23.
    Khosla S., Lufkin E.G., Hodgson S.F., Fitzpatrick L.A., Melton L.J. Epidemiology and clinical features of osteoporosis in young individuals. Bone 1994, 15: 551–555.PubMedCrossRefGoogle Scholar
  24. 24.
    Wishart J.M., Need A.G., Horowitz M., Morris H.A., Nordin B.E.C. Effect of age on bone density and bone turnover in men. Clin. Endocrinol. (Oxf.) 1995, 42: 141–146.CrossRefGoogle Scholar
  25. 25.
    Looker A.C., Orwoll E.S., Johnston C.C. Jr., Lindsay R.L., Wahner H.W., Dunn W.L., Calvo M.S., Harris T.B., Heyse S.P. Prevalence of low femoral bone density in older US adults from NHANES III. J. Bone Min. Res. 1997, 12: 1761–1768.CrossRefGoogle Scholar
  26. 26.
    Hadjidakis D., Kokkinakis E., Giannopoulos G., Merakos G., Raptis S.A. Bone mineral density of vertebrae, proximal femur and os calcis in woman Greek subjects as assessed by dual-energy x-ray absorptiometry comparison with other populations. Eur. J. Clin. Invest. 1997, 27: 219–227.PubMedCrossRefGoogle Scholar
  27. 27.
    Nguyen T., Sambrook P., Kelly P., Jones G., Lord S., Freud J., Erisman J. Prediction of osteoporotic fractures by postural instability and bone density. BMJ 1993, 307: 1111–1115.PubMedCentralPubMedCrossRefGoogle Scholar
  28. 28.
    Kelepouris N., Harper K.D., Gannon F., Kaplan F.S., Haddad J.G. Severe osteoporosis in men. Ann. Intern. Med. 1995, 123: 452–460.PubMedCrossRefGoogle Scholar
  29. 29.
    Orwoll E.S. Osteoporosis in men. Endocrinol. Metab. Clin. North Am. 1998, 27: 349–367.PubMedCrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 2001

Authors and Affiliations

  • G. E. Krassas
    • 1
  • F. G. Papadopoulou
    • 1
  • D. Doukidis
    • 1
  • Th. Konstantinidis
    • 1
  • K. Kalothetou
    • 1
  1. 1.Department of Endocrinology and Metabolism“Panagia” HospitalThessalonikiGreece

Personalised recommendations