Male Osteoporosis and a Diagnostic Algorithm for its Investigation
Asian Journal of Research and Reports in Endocrinology,
Osteoporosis is a leading cause of morbidity and mortality in elderly people. Increase understanding of osteoporosis and its complications has been seen in recent years. Osteoporosis and associated fractures are not restricted to postmenopausal women. Considering the rise in life expectancy, the incidence of fractures in men is growing. The main problem at this age is functional impairment and morbidity. Osteoporosis in males, often overlooked problem compared to osteoporosis in females. The number of articles deal only with the patient population of women. Better treatment strategies for this condition can be established by enhancing our knowledge on approach to diagnosis of osteoporosis in men. This review is aimed to provide its diagnostic algorithm for osteoporosis in men.
- Osteoporosis in men
- diagnostic algorithm
- risk factors
How to Cite
Lorentzon M, Cummings SR. Osteoporosis: The evolution of a diagnosis. Journal of Internal Medicine. 2015;277(6):650–661. Available:https://doi.org/10.1111/joim.12369
Gennari L, Bilezikian JP. Osteoporosis in men. Endocrinology & Metabolism Clinics of North America. 2007;36:399–419.
Siddiqui NA, Shetty KR, Duthie EH. Osteoporosis in older men: discovering when and how to treat it. Geriatrics. 1999;54(9):20–22;27–28, 30 passim.
Gullberg B, Johnell O, Kanis JA. World-wide projections for hip fracture. Osteoporosis International. (997;7(5):407–413.
Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporosis International. 2005;16
Watts, Nelson B, Adler RA., Bilezikian JP, Drake MT, Eastell R, et al. Osteoporosis in Men: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism. 2012;97(6): 1802–1822. Available:https://doi.org/10.1210/jc.2011-3045
Kiebzak GM, Beinart GA, Perser K., Ambrose CG, Siff SJ, Heggeness MH. Undertreatment of Osteoporosis in Men With Hip Fracture. Arch Intern Med. 2002;162(19):2217–2222. Available:https://doi.org/10.1001/archinte.162.19.2217
Porcelli T, Maffezzoni F, Pezzaioli LC, Delbarba A, Cappelli C, Ferlin A. Management of Endocrine Disease: Male osteoporosis: diagnosis and management - should the treatment and the target be the same as for female osteoporosis? European Journal of Endocrinology. 2020;183(3):R75–R93.
Panula J, Pihlajamäki H, Mattila VM, Jaatinen P, Vahlberg T, Aarnio P, et al. Mortality and cause of death in hip fracture patients aged 65 or older - a population-based study. BMC Musculoskeletal Disorders. 2011;12(1):105. Available:https://doi.org/10.1186/1471-247 4-12-105
Gagnon C, Li V, Ebeling PR. Osteoporosis in men: Its pathophysiology and the role of teriparatide in its treatment. In Clinical Interventions in Aging. 2008;3(4):635–645.
Farr JN, Khosla S. Skeletal changes through the lifespan—from growth to senescence. Nature Reviews Endocrinology. 2015;11(9):513–521. Available:https://doi.org/10.1038/nrendo.2015.89
Riggs BL, Melton LJ, Robb RA, Camp JJ., Atkinson EJ, McDaniel L, et al. A Population-Based Assessment of Rates of Bone Loss at Multiple Skeletal Sites: Evidence for Substantial Trabecular Bone Loss in Young Adult Women and Men. Journal of Bone and Mineral Research. 2007;23(2):205–214. Available:https://doi.org/10.1359/jbmr.071020
Khosla S, Amin S, Orwoll E. Osteoporosis in men. Endocr Rev. 2008;29(4):441–464. Available:https://doi.org/er.2008-0002 [pii]r10.1210/er.2008-0002
Ebeling PR. Osteoporosis in Men. New England Journal of Medicine. 2008; 358(14):1474–1482. Available:https://doi.org/10.1056/NEJMcp0707217
Eller-Vainicher C, Falchetti A, Gennari L, Cairoli E, Bertoldo F, Vescini F, et al. Diagnosis of Endocrine Disease: Evaluation of bone fragility in endocrine disorders. European Journal of Endocrinology. 2019;180(6):R213–R232. Available: https://doi.org/10.1530/EJE-18-0991
Gennari Luigi, Bilezikian JP. Osteoporosis in men: Pathophysiology and treatment. In Current Rheumatology Reports. 2007a;9, (1)71–77).
Gennari, Luigi, Bilezikian JP. Osteoporosis in Men. In Endocrinology and Metabolism Clinics of North America. 2007b;36;2:399–419. Available:https://doi.org/10.1016/j.ecl.2007.03.008
Gärdsell P, Johnell O, Nilsson BE. The predictive value of forearm bone mineral content measurements in men. Bone. 1990;11(4):229–232. Available;https://doi.org/10.1016/8756-328 2(90)900 7 4-9
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. Journal of Bone and Mineral Research : The Official Journal of the American Society for Bone and Mineral Research. 2006;21(10):1550–1556. Available:https://doi.org/10.1359/jbmr.060708
Kanis JA, McCloskey EV, Johansson H, Oden A, Melton LJ, Khaltaev N. A reference standard for the description of osteoporosis. In Bone. 2008;42(3):467–475. Available:https://doi.org/10.1016/j.bone.2007.11.001
Ebeling P. Clinical practice. Osteoporosis in men. The New England Journal of Medicine. 2008;358(14):1474–1482.
Shepherd AJ, Cass AR, Carlson CA, Ray L. Development and internal validation of the male osteoporosis risk estimation score. Annals of Family Medicine. 2007; 5(6):540–546. Available:https://doi.org/10.1370/afm.753
Mirza F, Canalis E. Management of Endocrine Disease: Secondary Osteoporosis: Pathophysiology and Management. European Journal of Endocrinology / European Federation of Endocrine Societies. 2015;1–52. Available:https://doi.org/10.1530/EJE-15-0118
Watts NB, Adler RA, Bilezikian JP, Drake MT, Eastell R, Orwoll ES, et al. Osteoporosis in men: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism. 2012;97(6):1802-1822,
Date of Publication: June 2012, 25 (United States RF-203 LG-English PT-Journal: Review DD-20120619), 1802–1822.
Available: http s://doi.org/10.1210/jc.2011-3045
Cosman F, De Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, et al. Clinician’s Guide to Prevention and Treatment of Osteoporosis. 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(10):2359–2381. Available: https://doi.org/10.1007/s00198-0 14-2794-2
Orwoll ES, Scheele WH, Paul S, Adami S, Syversen U, Diez Perez A, et al. The Effect of Teriparatide [Human Parathyroid Hormone (1-34)] Therapy on Bone Density in Men With Osteoporosis. Journal of Bone and Mineral Research. 2003;18(1):9–17. Available:https://doi.org/10.1359/jbmr.2003.18.1.9
Orwoll E, Ettinger M, Weiss S, Miller P, Kendler D, Graham J, et al. Alendronate for the Treatment of Osteoporosis in Men. New England Journal of Medicine. 2000;343(9):604–610. Available:https://doi.org/10.1056/NEJM200008313430902
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. Rheumatology International. 2009;29(3):311–315. Available: https://doi.org/10.1007/s00296-008-0689-2
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. Journal of Bone and Mineral Research. 2009;24(4):719–725. Available:https://doi.org/10.1359/jbmr.081214
Orwoll E, Teglbjærg CS, Langdahl BL, Chapurlat R, Czerwinski E, Kendler DL, et al. A Randomized, Placebo-Controlled Study of the Effects of Denosumab for the Treatment of Men with Low Bone Mineral Density. The Journal of Clinical Endocrinology & Metabolism. 2012;97(9): 3161–3169. Available:https://doi.org/10.1210/jc.2012-1569
Smith MR, Egerdie B, Toriz NH, Feldman R, Tammela TLJ, Saad F, et al. Denosumab in Men Receiving Androgen-Deprivation Therapy for Prostate Cancer. New England Journal of Medicine. 2009; 361(8):745–755. Available:https://doi.org/10.1056/NEJMoa0809003
Kaufman JM, Orwoll E, Goemaere S, San Martin J, Hossain A, Dalsky GP, Lindsay R, Mitlak BH. Teriparatide effects on vertebral fractures and bone mineral density in men with osteoporosis: Treatment and discontinuation of therapy. Osteoporosis International. 2005;16(5): 510–516. Available:https://doi.org/10.1007/s00198-004-1713-3
Amory JK, Watts NB, Easley KA, Sutton P. R, Anawalt BD, Matsumoto AM, et al. Exogenous Testosterone or Testosterone with Finasteride Increases Bone Mineral Density in Older Men with Low Serum Testosterone. The Journal of Clinical Endocrinology & Metabolism. 2004;89(2): 503–510. Available:https://doi.org/10.1210/jc.2003-031110
Tracz MJ, Sideras K, Boloña ER, Haddad RM, Kennedy CC, Uraga MV, et al. Testosterone Use in Men and Its Effects on Bone Health. A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials. The Journal of Clinical Endocrinology & Metabolism. 2006;91(6): 2011–2016. Available:https://doi.org/10.1210/jc.2006-0036
Abstract View: 36 times
PDF Download: 20 times