Abstract
BackgroundOsteoporosis and osteoporotic fracture in men are significant public health problems in an aging society. However, information on male osteoporosis remains impressively lacking, especially for Asians. We designed the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study as an ancillary study of a cohort study, the Fujiwara-kyo study, to determine risk factors for osteoporotic fractures in Japanese men.Methods/DesignDesign: A community-based single-centre prospective cohort study with at least a 5-year follow-upSubjects: All the male participants of the Fujiwara-kyo study who were living in the four cities studied, aged 65 years and older, and able to walk without aid from others.Primary outcome: Incidence of osteoporotic fractures including vertebral and clinical non-vertebral fractures.Additional outcomes: Change in bone mineral density (BMD), change in hip geometry, onset of receiving benefits from Long-term Care Insurance (LCI), health-related quality of life, and mortality.Baseline measurements: BMD at the lumbar spine (LS) and hip (TH), hip geometry, vertebral deformity assessment, bone turnover markers, physical and cognitive performance, various medical and lifestyle factors, and geriatric psychosocial measures confirmed by interviews based on self-administrated questionnaires.Outcome surveillance: Annual mail surveys and a follow-up survey at the fifth year comprising similar items to the baseline study will be used to determine the outcomes. Receipt of benefits from LCI and mortality will be obtained from the city governments.Current status: The baseline study was conducted for 2174 eligible men, and 2012 completed the study and were eligible for follow-up. Prevalence rates of osteoporosis (BMD 2.5 SD or more below the young adult mean (YAM)) and low BMD (BMD 1 SD or more below YAM) in at least one of LS and TH were calculated to be 4.4% and 41.8%, respectively. The proportion of men with low BMD only at TH showed a significant increasing trend with aging (p < 0.0001) while that only at LS showed a decreasing trend (p = 0.0386). The prevalence rate of osteoporosis was underestimated when diagnosed using only BMD at LS. Other baseline measurements were successfully obtained.DiscussionFORMEN baseline study was performed as designed and the FORMEN cohort study was successfully launched.
Highlights
Osteoporosis and osteoporotic fracture in men are significant public health problems in an aging society
We present in this paper the design of the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study and the baseline characteristics of its participants
General study description The FORMEN study is an ancillary study of a larger prospective cohort study, The Cohort Study for Functioning Capacity and Quality of Life in Elderly Japanese (Primary Investigator: Norio Kurumatani, M.D., Ph.D., Professor and Chairman, Department of Community Health and Epidemiology, Nara Medical University School of Medicine), which is referred to as the "Fujiwara-kyo study" after the study area where the first capital of Japan, called "Fujiwara-kyo," was established in 694 AD
Summary
Osteoporosis and osteoporotic fracture in men are significant public health problems in an aging society. Osteoporotic fracture is a significant and increasing public health burden, for men as well as women, in aging societies. There were 117,900 incident hip fractures estimated in 2002, double the number from 1987, of which 22% occurred in men [6]. This trend in the incidence of osteoporotic fractures urges us to establish a comprehensive strategy to prevent and manage osteoporosis in men as a national and international issue with the highest priority
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