Prevalence Of Osteoporosis In Men Research Articles

Osteoporosis in older men

Osteoporosis, characterized by reduced bone mass and compromised skeletal microarchitecture, significantly increases the risk of fractures and is the most prevalent metabolic bone disease. While it is commonly associated with post-menopausal women, osteoporosis and subsequent fractures are also substantial concerns in men. Men experience sustained bone loss after the sixth decade, with estimates indicating that 20% of Americans with osteopenia or osteoporosis are men. Approximately one in eight men over 50 will suffer an osteoporotic fracture, with hip fractures in men leading to a two- to threefold increase in mortality compared to women. The prevalence of osteoporosis in men has risen, doubling in prevalence since the early 1990s. Men generally have higher peak bone mass and greater bone size, offering some protection against osteoporosis; however, aging leads to increased bone resorption and decreased bone formation, exacerbated by lower androgen and estrogen levels. Secondary causes, such as hypogonadism and chronic glucocorticoid use, are prevalent in men. Diagnosis primarily involves bone mineral density (BMD) measurements using dual-energy X-ray absorptiometry (DXA), with fracture risk assessment tools like FRAX and MORES aiding in clinical decisions. Treatment includes calcium and vitamin D supplementation, bisphosphonates, denosumab, and anabolic agents like teriparatide and abaloparatide. Special considerations are necessary for men undergoing androgen deprivation therapy for prostate cancer due to accelerated bone loss. Effective management requires early diagnosis, lifestyle modifications, and appropriate pharmacological interventions to reduce fracture risk and improve patient outcomes.

Response rates for lumbar spine, total hip, and femoral neck bone mineral density in men treated with abaloparatide: results from the ATOM study.

Osteoporosis in men is an underappreciated public health issue, accounting for approximately 30% of the societal burden of osteoporosis. Although the prevalence of osteoporosis in men is lower, fracture-related morbidity and mortality rates exceed those of women. Abaloparatide is a synthetic, 34-amino acid peptide with homology to human parathyroid hormone-related protein (PTHrP), which favors bone formation by selective activation of PTH receptor type 1. In the Abaloparatide for the Treatment of Men With Osteoporosis (ATOM; NCT03512262) trial, 228 men with primary or hypogonadism-associated osteoporosis were randomized to receive subcutaneous injections of abaloparatide 80μg or placebo. Abaloparatide significantly improved LS, TH, and FN BMD when compared with placebo. In this prespecified analysis, the proportion of men with a percent change from baseline of >0%, >3%, and > 6% in BMD at the LS, TH, and FN at 3, 6, and 12mo and/or a shift in T-score category (based on LS and TH T-scores) at 12mo was compared between the abaloparatide and placebo groups in ATOM. There were significantly more men with a BMD gain of >3% at all 3 anatomical sites in the abaloparatide than placebo group at month 6 (18/122 [14.8%] vs 1/70 [1.4%], P = .002) and at month 12 (38/119 [31.9%] vs 1/66 [1.5%], P < .0001). At month 3, more men treated with abaloparatide than placebo had a > 3% BMD increase at the LS (82/134 [61.2%] vs 21/68 [30.9%], P < .0001). A greater proportion of men treated with abaloparatide had an improvement in T-score category from osteoporosis to low BMD or normal when compared with placebo. In conclusion, use of abaloparatide compared with placebo for 12mo resulted in significant and rapid improvements in BMD in men with osteoporosis from the ATOM study.

Bone Metabolism in Men who Live with HIV Aged 50 years and Over: Impact of Infection Duration.

Early diagnosis and effective antiretroviral therapy (ART) lead to similar life expectancy in people living with HIV (PLWH) compared to the general population. This population faces problems such as decreased bone mineral density (BMD) and increased fracture risk. The aim of this study was to determine the prevalence of osteoporosis in men aged 50 years and over who were PLWH and to determine risk factors and changes in bone metabolism with bone turnover markers. 79 male PLWH aged 50 years and over were followed up in our outpatient clinic between May 2021 and October 2021. The patients' demographic, clinical, laboratory, and DEXA data were analyzed. Serum levels of bone turnover markers were measured. The prevalence of osteopenia, osteoporosis, and normal BMD was found to be 55.7%, 13.9%, and 30.4%, respectively. A correlation was found between low BMD and low body mass index, elapsed time since diagnosis of HIV infection, high rate of use of ART, and long usage time of tenofovir disoproxil fumarate + protease inhibitor. A one-year increase in HIV infection duration was associated with an increased risk of low BMD by 1.246. Compared to studies conducted on the general population, the prevalence of osteoporosis in male PLWH aged 50 years and older was two times higher. The limited effect of the duration of ART use on low BMD may be due to the patients' histories of replacement therapy. Therefore, to eliminate the negative effects of ART on BMD, it may be beneficial to start replacement therapy when necessary.

228 GENDER DISPARITIES IN DIAGNOSING OSTEOPOROSIS

Abstract Background It is estimated that up to 300,000 people in Ireland have osteoporosis, however it is a disease most commonly associated with women. Women aged over 50 years have a four times greater rate of osteoporosis and are twice as likely to have osteopenia as men.1 However the recognition and treatment of osteoporosis in men cannot be forgotten. The Irish Hip Fracture Database National Report 2019 showed that 31% of 3,701 hip fractures that year were in males. Hip fractures have been shown to result in higher overall mortality in men than in women.2 Methods A retrospective observational study was carried out by analysing the reports of all dual-energy X-ray absorptiometry (DEXA) scans performed in a large university teaching hospital from January 1998 to August 2021, collecting data on gender, age, bone mineral density and osteoporosis risk factors. Results A total of 39,611 patients having their first DEXA scan in our hospital were included. 85.2% were female and 14.8% male. In all patients over 75 years, only 12.9% of all patients getting a first DEXA scan were male. Of all women who had DEXA scans, 29.1% were diagnosed with osteoporosis and 38.4% with osteopenia and in men 16.6% osteoporosis and 40.7% osteopenia. Conclusion Our results highlight that men have DEXA scans performed much less frequently than women. This is seen in all age groups, especially in patients over 75 years old. As in women, the prevalence of osteoporosis in men increases with age. This study demonstrates the importance of evaluating for and treating osteoporosis in men as well as women, as fragility fractures can cause significant mortality and morbidity in both genders.

The association between hemoglobin level and osteoporosis in a Chinese population with environmental lead and cadmium exposure.

Low hemoglobin (Hb) level or anemia is associated with osteoporosis and bone fracture. Cadmium (Cd) and lead (Pb) exposure are also risk factors of osteoporosis and anemia. However, the role of anemia in Cd/Pb related bone loss remains unclear. The aim of present study was to investigate the association between Hb level and bone loss in a population with environmental lead and cadmium exposure. One hundred and ninety-four women and 108 men with different levels of Cd/Pb exposure were included in our study. The Cd/Pb exposure was determined using graphite-furnace atomic absorption spectrometry. Forearm bone mineral density (BMD) was determined by peripheral dual-energy X-ray absortiometry. Hb concentration was determined using an automatic blood cellcounter. A logistic model was established to predict the risk of osteoporosis. The BMDs of women that had the highest quartile BCd and BPb were markedly lower than that with the lowest quartile (p < 0.05). The BMD and the prevalence of osteoporosis in men with anemia were lower and higher than that with normal Hb (p < 0.05), respectively. In men, age, BPb and anemia were independent risk factors for osteoporosis. The odds ratio (OR) of men with anemia was 11.28 (95%confidence interval (CI):1.94-65.54) and 19.56 (95%CI: 2.98-128.78) compared to those with normal Hb after adjusting for potential cofounders. No such association was found in women. The area under the curve was 0.88 (95%CI: 0.82-0.96) in predicting osteoporosis using the logistic model in men. Linear discriminant analysis also showed that 90.7% of osteoporosis was correctly classified. Our data show that anemia is associated with incident of osteoporosis in men but not in women that environmentally exposed to Pb and Cd.

Gender-specific prevalence and influencing factors of osteopenia and osteoporosis in Chinese rural population: the Henan Rural Cohort Study

ObjectiveThe aims of this study were to describe distributions of the prevalence of osteopenia and osteoporosis and identify the potential risk factors by gender in a Chinese rural population.DesignA cross-sectional...

Measurement of Forearm Bone Density by Dual Energy X-Ray Absorptiometry Increases the Prevalence of Osteoporosis in Men With Celiac Disease

Guidelines advise measurement of bone mineral density (BMD) in patients with a diagnosis of celiac disease. The lumbar spine (LS) and hip sites are usually measured. Although skeletal sites rich in trabecular bone are believed to be vulnerable to osteoporosis in patients with celiac disease, most studies have not measured the cortical distal 1/3-radius. We collected data from 721 patients (mean age, 43.6 years; 68.4% female) with celiac disease who underwent 3-site dual energy x-ray absorptiometry (DXA, at a median 1.22 years after diagnosis). We assessed skeletal site- and sex-specific osteoporosis prevalence and the incremental utility of 1/3-radius measurement by DXA. Mean T- and Z-scores were normal in patients, but 43.3% had osteopenia and 19.6% had osteoporosis. Osteoporosis was found in 12.1% of patients at the LS, 5.3% of patients at the total hip, 7.6% of patients at the femoral neck, and 11.5% of patients at the 1/3-radius. A greater degree of villous atrophy at diagnosis was associated with male sex and lower T-scores at the 1/3-radius (P = .03), but not other skeletal sites. Isolated forearm osteoporosis was detected in 4.9% of patients. A higher proportion of patients with isolated forearm osteoporosis were male and had a greater weight and body mass index (all P < .01, compared to patients with osteoporosis only at other sites). Z-scores were lower at the LS and 1/3-radius and osteoporosis was more common in men than women. In men, the 1/3-radius was the most frequent site for osteoporosis. Among patients 50 years or older, isolated forearm osteoporosis was present in 10.7%. Based on DXA analysis of patients with celiac disease, the prevalence of osteoporosis appears to be underestimated-particularly in men when BMD at the 1/3-radius is not measured. Degree of villous atrophy is associated with BMD at the 1/3-radius and nearly 5% of patients have osteoporosis limited to that site. Recommendations for osteoporosis screening in patients with celiac disease should include measurement of the distal 1/3-radius in addition to the hip and LS.

Metformin and Lifestyle Interventions in DPP Do Not Have Long-Term Effects on Bone Density or Falls

Randomization to lifestyle intervention (ILS) or metformin (MET) in the Diabetes Prevention Program (DPP) resulted in weight loss and reduced progression to diabetes. The long term effects of these interventions on bone mineral density (BMD) and falls, both associated with weight loss, are not known. We determined if ILS or MET was associated with prevalence of osteoporosis, osteopenia or history of falls in the DPP Outcome Study (DPPOS). During DPP, 3234 participants at high risk for diabetes were randomized to ILS, MET or PLB; 2779 continued in DPPOS and were offered modified group ILS. During DPPOS, ILS was offered additional lifestyle reinforcement semi-annually and MET received unmasked metformin. This analysis includes 1384 DPPOS participants who had dual-energy X-ray absorptiometry hip scans at year 12 (Y12). Osteoporosis was defined as femoral neck BMD T-score ≤-2.5 and osteopenia as -2.5&amp;lt;T-score≤-1. Participants were asked at Y12 if they had a fall in the previous year. Outcomes were compared across the 3 treatment groups using Pearson’s chi- squared test. Associations between treatment and outcomes were assessed with logistic regression. Mean age at Y12 was 66.5 (±9.5) years. Mean time since DPP baseline was 15.6 (±0.7) years. Weight loss (DPP baseline to DPPOS Y12) did not differ across treatment groups (-4.4 kg ILS; -3.5 kg MET; -3.1 kg PLB; p=0.114). There were no differences across groups in the prevalence of osteoporosis in men (1.4% ILS, 1.3% MET, 0.7% PLB; p=0.836) or women (2.9% ILS, 2.9% MET, 3.1% PLB; p=0.983). Prevalence of osteopenia was also similar across groups. Prevalence of history of falls was similar across groups in men (16.0% ILS, 16.4% MET, 16.0% PLB; p=0.995) and women (25.7% ILS, 21.3% MET, 21.6% PLB; p=0.342). Prevalence of osteoporosis, osteopenia or history of falls did not differ between ILS or MET and PLB in men or women. In a cohort at high risk of diabetes, lifestyle intervention or metformin did not have long-term effects on bone density or falls. Disclosure A.V. Schwartz: None. Q. Pan: None. V. Aroda: Consultant; Self; Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc., AstraZeneca, Calibra Medical, Eisai Inc., Sanofi. Consultant; Self; Sanofi. Research Support; Self; Theracos, Inc.. Employee; Spouse/Partner; Merck &amp; Co., Inc.. Other Relationship; Self; American Diabetes Association. Consultant; Self; ADOCIA. J.P. Crandall: None. A. Kriska: None. C.S. Piromalli: None. M. Temprosa: Other Relationship; Self; Merck KGaA. H. Florez: Advisory Panel; Self; Sanofi. D. Research Group: None.

Prevalence of Osteoporosis in Apparently Healthy Adults above 40 Years of Age in Pune City, India.

Purpose:The aim of study was to assess the prevalence of osteoporosis and changes in bone mass with increasing age and compare bone health status of apparently healthy men, premenopausal and postmenopausal women.Methods:Data were collected on anthropometric and sociodemographic factors in 421 apparently healthy Indian adults (women = 228), 40–75 years of age, in a cross-sectional study in Pune city, India. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry at two sites-lumbar spine (LS) and left femur. Individuals were classified as having osteoporosis or osteopenia based on the World Health Organization criteria of T-scores.Results:Mean age of study population was 53.3 ± 8.4 years. Of the total women, 44.3% were postmenopausal with 49.2 ± 3.5 years as mean age at menopause. Postmenopausal women showed a rapid decline in BMD with age till 50 years while men showed a gradual decline. Premenopausal women showed no significant decline in BMD with age (P > 0.1). Significantly lower T-scores were observed at LS in men compared to premenopausal (P < 0.05). At left femur, T-scores were lower in men compared to premenopausal women (P < 0.05) but not postmenopausal women (P > 0.1). The prevalence of osteoporosis in men at LS was lower than postmenopausal women but higher than premenopausal women.Conclusion:In Indian men, a low T-score compared to women indicates higher susceptibility to osteoporosis. In women, menopause causes a rapid decline in BMD. Therefore, both Indian men and postmenopausal women require adequate measures to prevent osteoporosis during later years in life.

Osteoporosis in Mongolian Population: Prevalence and Risk Factors

Objectives: The purpose of this study was to evaluate the prevalence of osteoporosis and investigate some of its risk factors among Mongolian adults. Methods: The subjects comprised of 2001 adults (age ranged from 20 to 87) were recruited from 5 ecological zones of Mongolia. After applying exclusion criteria, 1990 subjects were selected. Speed of sound (SOS) ultrasonic bone mineral density was measured in the distal one third of radius of the non-dominant arm using the Sunlight Omnisense (Sunlight Medical, Rehovot, Israel). The data were used to calculate mean SOS and T-score by WHO osteoporosis criteria. Results: The average age was 49.1±13.5 (men: 48.6±14.6, women: 49.4±13.0). The prevalence of osteoporosis in men and women from 20-35 years of age was 4.7% vs 6.2%, from 36-45 years of age was 7.2% vs 8.0%, from ages 46-55 was 11.4% vs 25.5%, from ages 56-65 was 21.9% vs 58.3%, and from those over 65 years of age was 35.6% vs 75.5%. The prevalence of osteoporosis was lowest in Ulaanbaatar city. The independent predictors of osteoporosis in Mongolian adults were female sex, menopause, lower education level, physical inactivity and low BMI (BMI&lt;18.5). Conclusion: Compared to neighboring and industrialized countries, the prevalence of osteoporosis in Mongolia is significantly higher. Female sex, lack of exercise, lower education level, menopause and being underweight were identified as risk factors in Mongolian adults.

Bone mineral density at distal forearm in men over 40 years of age in Mae Chaem district, Chiang Mai Province, Thailand: a pilot study

Objective: To study the prevalence of bone mineral density (BMD) and osteoporosis in the distal forearm among Thai men over 40 years of age in Mae Chaem District, Chiang Mai Province, Thailand.Methods: The subjects in this study were 194 Thai men, aged between 40 and 87 years who resided in Mae Chaem District, Chiang Mai Province, Thailand. Self-administered questionnaires were used for receiving the demographic characteristics information. BMD was measured by peripheral dual energy X-ray absorptiometry at the nondominant distal forearm in all men.Results: The BMD was highest in the age-group 40–49 years and lowest in the age-group 70–87 years. The average T-score at the distal forearm was also highest in the age-group 40–49 years and lowest in the age-group 70–87 years. The BMD decreased as a function of age-group (p < .05). In contrast, the BMD increased as a function of weight (p < .05). Height had weak impact on the BMD in the distal forearm (p > .05). The percentage of osteopenia and osteoporosis are increased as a function of age-group in, while decreased in that of normal bone density.Conclusions: We found the prevalence of osteoporosis in men who resided in Mae Chaem District, Chiang Mai Province, Thailand.

High Prevalence of Osteoporosis in Men with Distal Radius Fracture: A Cross-Sectional Study of 233 Men

Distal radius fracture is an early indicator of osteoporosis, yet little is known about men with this fracture and osteoporosis prevalence. The purpose of this cross-sectional, controlled study was to evaluate bone mineral density (BMD) in men, from working age to the elderly, with distal radius fracture. Recruitment was as follows: men who fractured during 1999-2000 were evaluated retrospectively in 2003 and men who fractured during 2003-2007 were followed prospectively for one year post-fracture. A total of 233 patients, response rate 40%, were enrolled and compared with 643 controls. Fractures from all degrees of trauma were included. BMD was measured at femoral neck, total hip, and lumbar spine. Mean age at fracture was 52years (21-88years). Men aged 40-64years had 5.4-6.7% lower BMD at all sites compared to controls (p=0.001) and in >65years BMD was lower by 10.7-13.8% (p<0.001), while not significant at <40years (1.4-2.8%; p=0.228-0.487). Osteoporosis was more prevalent at all ages (20-39years: 8.5 vs 1.5%; 40-64years: 16.8 vs 5.1%; >65years: 23.3 vs 8.3%) BMD did not differ with trauma level. Already from age 40, men with a distal radius fracture had lower BMD, the difference becoming more pronounced with increasing age. Also, the prevalence of osteoporosis was higher, surprisingly even in the youngest age group.

Association of bone mineral density and diabetic retinopathy in diabetic subjects: the 2008-2011 Korea National Health and Nutrition Examination Survey.

Because diabetic retinopathy increases fracture risk, we studied the association between bone mineral density (BMD) and diabetic retinopathy in a nationally representative sample. A significant association between the presence of diabetic retinopathy and low BMD was observed. Therefore, diabetic retinopathy might be considered as a marker of low BMD. Several diabetic complications, including nephropathy, retinopathy, and peripheral neuropathy, are associated with a higher fracture risk in diabetic subjects. However, in contrast to diabetic nephropathy and peripheral neuropathy, which are associated with low bone mineral density (BMD), little is known about the association between BMD and diabetic retinopathy. The aim of the present study was to determine whether the prevalence of diabetic retinopathy is associated with BMD. This cross-sectional study included a nationally representative sample consisting of 4357 men aged 50years and older and 4392 postmenopausal women who participated in the Korea National Health and Nutritional Examination Survey (KNHANES) from 2008 to 2011 and underwent BMD measurement by dual-energy X-ray absorptiometry (DXA) and diabetic retinopathy assessments using seven standard gradable photographs. The diabetic women with retinopathy had lower mean BMD at all measured sites than those without retinopathy, although the BMD difference between the two groups was small (3-5%). In addition, the diabetic women with retinopathy were 2.27 times more likely to have osteoporosis following adjustments for all clinically relevant covariates. However, the prevalence of diabetes mellitus (DM) or diabetic retinopathy was not associated with the prevalence of osteoporosis in men. This study has shown that the presence of diabetic retinopathy is significantly associated with a reduced BMD and increased prevalence of osteoporosis in diabetic women.

Osteoporosis in men: findings from the Osteoporotic Fractures in Men Study (MrOS).

The lifespan of men is increasing and this is associated with an increased prevalence of osteoporosis in men. Osteoporosis increases the risk of bone fracture. Fractures are associated with increased disability and mortality, and public health problems. We review here the study of osteoporosis in men as obtained from a longitudinal cohort of community-based older men, the Osteoporotic Fractures in Men Study (MrOS).

Prevalence of osteoporosis in prostate cancer survivors II: a meta-analysis of men not on androgen deprivation therapy.

The prevalence of osteoporosis in men with prostate cancer (PCa) on androgen deprivation therapy (ADT) is well documented, with up to 53% affected by this bone condition. However, there has been less emphasis on the burden of severe bone loss in men with PCa but not undergoing ADT. Therefore, the purpose of this meta-analysis is to compile evidence from the literature on the bone health of hormone-naïve PCa patients and to compare it to the bone health of men with PCa on ADT. Three databases were searched for the relevant literature published from 1990 until January 2014. The pooled prevalence of osteoporosis, low bone mass, and normal bone mass were estimated for this patient group and compared with similar subgroups from a previously published meta-analysis. The prevalence of osteoporosis varies from 4 to 38% in hormone-naïve PCa patients, and men with more advanced disease have a higher prevalence of osteoporosis. Men with PCa on ADT have poorer bone health than their hormone-naïve counterparts, but the trend toward poorer bone health with metastatic disease remains. In conclusion, it was found that men with PCa experience poor bone health prior to treatment with ADT. These results suggest that all men with PCa should have regular bone health monitoring, whether they commence ADT or not, in order to prevent or indeed minimize the morbidity that accompanies osteoporosis.

AB0608 Bone mineral density and body composition by dual energy x-ray absorptiometry in men with rheumatoid arthritis

BackgroundLoss of bone mineral density (BMD) and muscle mass are common symptoms in patients with rheumatoid arthritis (RA). Changes in body composition in men with RA have been little studied.ObjectivesTo...

Age-Related Changes in the Prevalence of Osteoporosis according to Gender and Skeletal Site: The Korea National Health and Nutrition Examination Survey 2008-2010.

BackgroundThe incidence of osteoporosis and its related fractures are expected to increase significantly in the rapidly aging Korean population. Reliable data on the prevalence of this disease is essential for treatment planning. However, sparse data on Korean patients is available.MethodsWe analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2008 to 2010. Bone mineral density (BMD) was measured at the femoral neck and lumbar spine using dual-energy X-ray absorptiometry. Osteopenia and osteoporosis were diagnosed according to the World Health Organization T-score criteria. We analyzed the BMD data of 17,208 people (men, 7,837; women, 9,368).ResultsThe adjusted prevalence of osteoporosis was 7.8% in men versus 37.0% in women. No significant difference was observed in the prevalence of osteopenia between genders (men, 47.0%; women, 48.7%). The prevalence of osteoporosis in men in their 50s was 4.0%, in their 60s was 7.2%, in their 70s was 15.1%, and in their 80s was 26.7%. The figures in women were 15.2%, 36.5%, 62.7%, and 85.8%, respectively. The age group with the maximal BMD differed between genders. In the men, 20s had the highest value in all the skeletal sites. However, in the women, the maximal BMD in the femoral neck, lumbar spine, and the total hip was observed in their 20s, 30s, and 40s, respectively. The onset age of osteoporosis differed between genders. Osteoporosis in the femoral neck began at 55 years in the women and at 60 years in the men.ConclusionThe prevalence of osteoporosis in Korea was significantly high. In addition, the age-related changes in the prevalence of osteoporosis differed according to gender and skeletal site.

Bone Mineral Density Changes in Male Patients With Chronic Obstructive Pulmonary Disease: Clinical and Biochemical Variables in Correlation With Glucocorticoids Use

PURPOSE: Few data are available in correlation between bone mass density (BMD) and men with COPD This study was designed to investigate the prevalence of osteoporosis in men with COPD. with special regards to the role of glucocorticoids (GCs) use in these patients

Effectiveness of alendronate and etidronate in the treatment of osteoporosis in men: a prospective observational study

The prevalence of osteoporosis in men is higher than previously assumed; consequently, numerous therapies are being investigated to treat these patients. The Canadian Database of Osteoporosis and Osteopenia patients (CANDOO) was analyzed to examine changes in bone mineral density (BMD) in consecutively seen osteoporotic men administered alendronate, etidronate or no bone-active drugs (control) over 1 year. A total of 244 men attending six Canadian osteoporosis clinics were included in the study (42 alendronate, 102 etidronate and 100 control). Multiple imputation was used to model missing data to provide a more robust statistical model. The imputed datasets (five) were analyzed using multivariable linear regression to determine differences between groups in the percent change of lumbar spine (LS) and femoral neck (FN) BMD from baseline to 1 year. Differences in the percent change in BMD from baseline were most notable at the LS in favor of alendronate (4.3%; 95% CI: 2.1, 6.6 ) and etidronate (2.1%; 95% CI: 0.3, 4.0) therapy when compared with controls. At the LS, alendronate therapy led to significantly greater (2.2%; 95% CI: 0.2, 4.2) gains in BMD as compared to etidronate therapy. Compared to controls, there were no significant differences in FN BMD with alendronate (2.1%; 95% CI: -0.4, 4.7) or etidronate therapy (0.9%; 95% CI: -1.1, 2.8), nor were there significant differences between bisphosphonate groups (1.3%; 95% CI: -1.1, 3.6, in favor of alendronate). While both alendronate and etidronate significantly increased LS BMD in osteoporotic men after 1 year in real-world settings, alendronate therapy resulted in significantly superior gains in LS BMD. The effect of these two bisphosphonates on fractures and FN BMD in osteoporotic men is likely positive, but requires further study.

Osteoporosis en el varón con enfermedad pulmonar obstructiva crónica. Utilidad de la densitometría de falange (AccuDEXA) como método de cribado diagnóstico

To analyze the prevalence of osteoporosis in men with chronic obstructive pulmonary disease (COPD) and to evaluate whether phalangeal densitometry (AccuDEXA) could be a useful screening method for identifying osteoporosis in these patients. We performed a cross sectional study in male patients with COPD who were assessed by a pulmonologist in primary care and in our hospital as out-patients. The diagnosis of osteoporosis was established by conventional DEXA (lumbar spine and total hip), according to the WHO criteria. Bone mineral density (BMD) was assessed by AccuDEXA. We used a ROC curve to determine the best cut-off point for screening with this technique. One hundred fifty male patients with COPD were included. The mean age was 67 ± 3 years. The prevalence of osteoporosis by DEXA was 34%. BMD in phalanx was significantly correlated with BMD in lumbar spine and hip (r: 0.6). The sensitivity and specificity of AccuDEXA in identifying osteoporosis was 29% and 85%, respectively. The best cut-off point for AccuDEXA was a T-score of -0.8 (sensitivity 85%, specificity 63%, positive predictive value 56%, negative predictive value 89%). Glucocorticoid treatment and COPD severity were significantly associated with the presence of osteoporosis in these patients (p=0.005 and p=0.023 respectively). The prevalence of osteoporosis in men with COPD is high. This complication seems to be associated with glucocorticoid treatment and COPD severity. AccuDEXA could be a useful screening method for osteoporosis in these patients and could almost halve the number of conventional DEXAs performed.