Osteoporosis is a bone condition characterized by a decrease in mineral density, resulting in bones that are brittle and liable to fracture. Approximately 25 percent of older women have osteoporosis. Although osteoporosis is most common in women, the disease can also affect men. About one in eight men over 50 have osteoporosis and more men die following a fracture than women. Now a study has reviewed osteoporosis guidelines for men.
The review, published in the Canadian Medical Association Journal, analyzed current literature to develop guidelines for the diagnosis and management of osteoporosis in men. The review supplemented previous guidelines published in 2002 by Osteoporosis Canada. The review found that those at highest risk for osteoporosis and fracture include men aged 65 years or older, men 50 or older with previous fragility fracture, men receiving glucocorticoid therapy for more than 3 months and men with clinical hypogonadism (impaired function of the testes). Other risk factors include hyperparathyroidism, vitamin D deficiency, and increased urinary excretion of calcium. Height loss and back pain can also be considered a risk factor as it may reflect underlying vertebral compression fractures.
The review recommends bone mineral density testing for all men over 65 and for younger men with other risk factors for fracture. Men and women have similar lifestyle and nutritional treatment recommendations for osteoporosis. Treatment with bisphosphonate drugs and 800 IU of vitamin D are recommended. Testosterone therapy is also recommended for men with symptoms of hypogonadism.
"Osteoporosis is underdiagnosed in older men, despite its significant association with disability and death," the study authors write. "With appropriate management, the fracture burden can now be reduced."
REFERENCES:
1. Khan AA et al. Management of osteoporosis in men: an update and case example. CMAJ 2007 Jan 30;176(3):345-8.
Posted by Elaine Gavalas on February 11, 2007 03:31 PM
