Men at Risk for Osteoporosis

Although osteoporosis (low bone mass density or BMD) is considered primarily a problem for older women, a 60-year-old white man has a 25 percent lifetime risk of suffering a bone fracture due to osteoporosis, reports the Agency for Healthcare Research and Quality (AHRQ). Osteoporosis is typically without symptoms and is substantially under-diagnosed and undertreated among men in the United States. A new study reveals certain risk factors for osteoporosis among asymptomatic men can be used to identify those who should be screened for the problem.

In reviewing studies on the topic from 1990 to 2007, a team of researchers revealed the key risk factors for low BMD-mediated fracture include advanced age, low body weight, greater than 10 percent weight loss, physical inactivity, prolonged corticosteroid use, previous osteoporotic fracture, and androgen deprivation therapy. Cigarette smoking was associated with lower BMD, but not as significant.

The studies also showed that non-DXA (dual-energy X-ray absorptiometry) tests are either too insensitive or have insufficient data to reach conclusions.

The study was supported in part by the AHRQ. You’ll find the rest of this story on the AHRQ Web site, and complete details in “Screening for osteoporosis in men: A systematic review for an American College of Physicians guideline,” by Hau Liu, M.D., M.B.A., M.P.H., Neil M. Paige, M.D., M.S.H.S., Caroline L. Goldzweig, M.D., M.S.H.S., and others, in the May 6, 2008, Annals of Internal Medicine 148, pp. 685-701.

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