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Epidemiology and pathophysiology of osteoporosis in men

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Abstract

Osteoporosis in men is an unrecognized but growing problem as the number of men who live to old age increases. The 10-year fracture risk at age 50 quadruples by age 80, and in general the incidence rate of osteoporotic fracture in men is about half that of women. Of note, the mortality and morbidity after hip fracture are much greater in men. There are many men whose osteoporosis is the result of specific causes such as oral glucocorticoid therapy, hypogonadism, or androgen withdrawal therapy for prostate cancer. In addition there are several interesting syndromes of osteoporosis in middle-aged men; these men usually present with vertebral fractures. As knowledge about the prevalence and etiology of osteoporosis in men increases, it will be recognized and treated in more men, in hopes of preventing fracture.

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References and Recommended Reading

  1. Kanis JA, Johnell O, Oden A, et al.: Long-term risk of osteoporotic fracture in Malmo. Osteoporos Int 2000, 11:669–674.

    Article  PubMed  CAS  Google Scholar 

  2. Jones G, Nguyen T, Sambrook PN, et al.: Symptomatic fracture incidence in elderly men and women: the Dubbo Osteoporosis Epidemiology Study (DOES). Osteoporos Int 1994, 4:277–282.

    Article  PubMed  CAS  Google Scholar 

  3. Block JE, Stubbs H: Hip fracture-associated mortality reconsidered. Calcif Tissue Int 1997, 61:84.

    Article  PubMed  CAS  Google Scholar 

  4. Tracy JK, Meyer WA, Grigoryan M, et al.: Racial differences in the prevalence of vertebral fractures in older men: the Baltimore Men’s Osteoporosis Study. Osteoporos Int 2006, 17:99–104.

    Article  PubMed  Google Scholar 

  5. Selby PL, Davies M, Adams JE: Do men and women fracture bones at similar bone densities? Osteoporos Int 2000, 11:153–157.

    Article  PubMed  CAS  Google Scholar 

  6. International Society for Clinical Densitometry: ISCD Official Positions. Available at www.iscd.org/Visitors/ positions/OfficialPositionsText.cfm. Accessed June 5, 2006.

  7. Looker AC, Orwoll ES, Johnston CC Jr, et al.: Prevalence of low femoral bone density in older U.S. adults from NHANES III. J Bone Miner Res 1997, 12:1761–1768.

    Article  PubMed  CAS  Google Scholar 

  8. Schuit SCE, van der Klift M, Weel AEAM, et al.: Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone 2004, 34:195–202.

    Article  PubMed  CAS  Google Scholar 

  9. Melton LJ 3rd, Atkinson EJ, O’Connor MK, et al.: Bone density and fracture risk in men. J Bone Miner Res 1998, 13:1915–1923.

    Article  PubMed  Google Scholar 

  10. Tuck SP, Raj N, Summers GD: Is distal forearm fracture in men due to osteoporosis? Osteoporos Int 2002, 13:630–636.

    Article  PubMed  CAS  Google Scholar 

  11. Bruder JM, Ma JZ, Basler JW, Welch MD: Prevalence of osteopenia and osteoporosis by central and peripheral bone mineral density in men with prostate cancer during androgen-deprivation therapy. Urology 2006, 67:152–155.

    Article  PubMed  Google Scholar 

  12. Petkov VI, Williams MI, Via PS, et al.: Dual energy x-ray absorptiometry (DXA) of the forearm in men: radius versus total. J Bone Miner Res 2004, 19(suppl:1):S234, #SU125.

    Google Scholar 

  13. De Laet C, Kanis JA, Oden A, et al.: Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 2005, 16:1330–1338.

    Article  PubMed  Google Scholar 

  14. Meier C, Nguyen TV, Center JR, et al.: Bone resorption and osteoporotic fractures in elderly men: the Dubbo Osteoporosis Epidemiology Study. J Bone Miner Res 2005, 20:579–587.

    Article  PubMed  Google Scholar 

  15. Naves M, Diaz-Lopez JB, Gomez C, et al.: Prevalence of osteoporosis in men and determinants of changes in bone mass in a non-selected Spanish population. Osteoporos Int 2005, 16:603–609.

    Article  PubMed  CAS  Google Scholar 

  16. van der Klift M, de Laet CE, McCloskey EV, et al.: Risk factors for incident vertebral fractures in men and women: the Rotterdam Study. J Bone Miner Res 2004, 19:1172–1180.

    Article  PubMed  Google Scholar 

  17. Adler RA, Funkhouser HL, Petkov VI, et al.: Osteoporosis in pulmonary clinic patients: does point-of-care screening predict central dual-energy x-ray absorptiometry? Chest 2003, 123:2012–2018.

    Article  PubMed  Google Scholar 

  18. Adler RA, Tran MT, Petkov VI: Performance of the osteoporosis self-assessment screening tool for osteoporosis in American men. Mayo Clin Proc 2003, 78:723–727.

    Article  PubMed  Google Scholar 

  19. Cauley JA, Fullman RL, Steone KL, et al.: Factors associated with the lumbar spine and proximal femur bone mineral density in older men. Osteoporos Int 2005, 16:1525–1537. A large, ongoing study of osteoporosis in older men.

    Article  PubMed  Google Scholar 

  20. Cheung EY, Ho AY, Lam KF, et al.: Determinants of bone mineral density in Chinese men. Osteoporos Int 2005, 16:1481–1486.

    Article  PubMed  CAS  Google Scholar 

  21. Riggs BL, Melton LJ 3rd: Involutional osteoporosis. N Engl J Med 1986, 314:1676–1686.

    Article  PubMed  CAS  Google Scholar 

  22. Bilezikian JP: Osteoporosis in men. J Clin Endocrinol Metab 1999, 84:3431–3434.

    Article  PubMed  CAS  Google Scholar 

  23. Zerwekj JE, Sakhaee K, Breslau NA, et al.: Impaired bone formation in male idiopathic osteoporosis. Osteoporos Int 1992, 2:128–134.

    Article  Google Scholar 

  24. Kurland ES, Rosen CJ, Cosman F, et al.: Insulin-like growth factor I in men with idiopathic osteoporosis. J Clin Endocrinol Metab 1997, 82:2799–2805.

    Article  PubMed  CAS  Google Scholar 

  25. Rosen CJ, Kurland ES, Vereault D, et al.: Association between serum insulin growth factor-I (IGF-I) and a simple sequence repeat in the IGF-I gene: implications for genetic studies of bone mineral density. J Clin Endocrinol Metab 1998, 83:2286–2290.

    Article  PubMed  CAS  Google Scholar 

  26. Van Pottelbergh I, Goemaere S, Zmierczak H, Kaufman JM: Perturbed sex steroid status in men with idiopathic osteoporosis and their sons. J Clin Endocrinol Metab 2004, 89:4949–4953.

    Article  PubMed  CAS  Google Scholar 

  27. Al-oanzi ZH, Tuck SP, Raj N, et al.: Assessment of vitamin D status in male osteoporosis. Clin Chem 2006, 52:248–254.

    Article  PubMed  CAS  Google Scholar 

  28. Kurland ES, Cosman F, McMahon DJ, et al.: Parathyroid hormone as a therapy for idiopathic osteoporosis in men: effects on bone mineral density and bone markers. J Clin Endocrinol Metab 2000, 85:3069–3076.

    Article  PubMed  CAS  Google Scholar 

  29. Fitzpatrick LA: Secondary causes of osteoporosis [review]. Mayo Clin Proc 2002, 77:453–468.

    Article  PubMed  Google Scholar 

  30. Steinbuch M, Youket TE, Cohen S: Oral glucocorticoid use is associated with an increased risk of fracture. Osteoporos Int 2004, 15:323–328.

    Article  PubMed  CAS  Google Scholar 

  31. Adler RA, Hochberg MC: Suggested guidelines for evaluation and treatment of glucocorticoid-induced osteoporosis for the Department of Veterans Affairs. Arch Intern Med 2003, 254:486–493.

    Google Scholar 

  32. Pearce G, Tabensky DA, Delmas PD, et al.: Corticosteroidinduced bone loss in men. J Clin Endocrinol Metab 1998, 83:801–806.

    Article  PubMed  CAS  Google Scholar 

  33. Van Staa TP, Leufkens HG, Abenhaim L, et al.: Use of oral corticosteroids and risk of fractures. J Bone Miner Res 2000, 15:993–1000.

    Article  PubMed  Google Scholar 

  34. Behre HM, Kliesch S, Leifke E, et al.: Long-term effect of testosterone therapy on bone mineral density in hypogonadal men. J Clin Endocrinol Metab 1997, 82:2386–2390.

    Article  PubMed  CAS  Google Scholar 

  35. Lopez AM, Pena MA, Hernandez R, et al.: Fracture risk in patients with prostate cancer on androgen deprivation therapy. Osteoporos Int 2005, 16:707–711.

    Article  PubMed  CAS  Google Scholar 

  36. Kanis JA, Johansson H, Johnell O, et al.: Alcohol intake as a risk factor for fracture. Osteoporos Int 2005, 16:737–742.

    Article  PubMed  Google Scholar 

  37. Farhat G, Yamout B, Mikati MA, et al.: Effect of antiepileptic drugs on bone density in ambulatory patients. Neurology 2002, 58:1348–1353.

    PubMed  CAS  Google Scholar 

  38. Misra M, Papakostas GI, Klibanski A: Effects of psychiatric disorders and psychotropic medications on prolactin and bone metabolism. J Clin Psychiatry 2004, 65:1607–1618.

    Article  PubMed  CAS  Google Scholar 

  39. Daniell HW: Hypogonadism in men consuming sustainedaction oral opioids. J Pain 2002, 3:377–384.

    Article  PubMed  Google Scholar 

  40. Silverberg S, Gartenberg F, Jacobs T, et al.: Longitudinal measurements of bone density and biochemical indices in untreated primary hyperparathyroidism. J Clin Endocrinol Metab 1995, 80:723–728.

    Article  PubMed  CAS  Google Scholar 

  41. Mohr BA, Guay AT, O’Donnell AB, McKinlay JB: Normal, bound and nonbound testosterone levels in normally ageing men: results from the Massachusetts Male Ageing Study. Clin Endocrinol (Oxf) 2005, 62:64–73.

    Article  CAS  Google Scholar 

  42. Meier DE, Orwoll ES, Keenan EJ, Fagerstrom RM: Marked decline in trabecular bone mineral content in healthy men with age: lack of association with sex steroid levels. J Am Geriatr Soc 1987, 35:189–197.

    PubMed  CAS  Google Scholar 

  43. Khosla S, Melton LJ III, Atkinson EJ, et al.: Relationship of serum sex steroid levels and bone turnover markers with bone mineral density in men and women: a key role for bioavailable estrogen. J Clin Endocrinol Metab 1998, 83:2266–2274.

    Article  PubMed  CAS  Google Scholar 

  44. Amory JK, Watts NB, Easley KA, et al.: Exogenous testosterone or testosterone with nasteride increases bone mineral density in older men with low serum testosterone. J Clin Endocrinol Metab 2004, 89:503–510.

    Article  PubMed  CAS  Google Scholar 

  45. Khosla S, Riggs BL, Atkinson EJ, et al.: Effects of sex and age on bone microstructure at the ultradistal radius: a population-based noninvasive in vivo assessment. J Bone Miner Res 2006, 21:124–131. Using this exciting new technique, virtual bone biopsy will lead to new insights.

    Article  PubMed  Google Scholar 

  46. Welch A, Camus J Dalzell N, et al.: Broadband ultrasound (BUA) of the heel bone and its correlates in men and women in the EPIC-Norfolk cohort: a cross-sectional populationbased study. Osteoporos Int 2004, 15:217–225.

    Article  PubMed  Google Scholar 

  47. Fujiwara S, Sone T, Yamazaki K, et al.: Heel bone ultrasound predicts non-spine fracture in Japanese men and women. Osteoporos Int 2005, 16:2107–2112.

    Article  PubMed  CAS  Google Scholar 

  48. Adler RA, Funkhouser HL, Holt CM: Utility of heel ultrasound bone density in men. J Clin Densitom 2001, 4:225–230.

    Article  PubMed  CAS  Google Scholar 

  49. Lynn HS, Lau EMC, Wong SYS, Hong AWL: An osteoporosis screening tool for Chinese men. Osteoporos Int 2005, 16:829–834.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Robert A. Adler MD.

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Adler, R.A. Epidemiology and pathophysiology of osteoporosis in men. Curr Osteoporos Rep 4, 110–115 (2006). https://doi.org/10.1007/s11914-996-0030-5

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