[Early, noninvasive diagnostic of osteoporosis in men]

Osteoporosis is the most frequent metabolic bone disease. Until recently it was believed to mainly affect women in menopause. A review of the literature indicates that a lot of the research to date on women. The patogenesis of bone loss in men has not been explained yet. It has not been determined what is the contribution of androgens as opposed to environmental factors and stimulants. The behaviour of bone turnover markers during ageing and their role in diagnosing the risk of osteoporosis development and fractures in men are not clear. The objective of the paper was to evaluate bone metabolism markers and to determine their relevance in early diagnosis of osteoporosis in men, and to determine any possible impact of testosterone concentration on bone mass. The study covered 100 volunteers-males, aged 40-85. All were subjected to a densitometric examination, using theDEXA method, of three regions of the osseous system: lumbar spine in anterior-posterior height, proximal femur, distal radius. Based on these results, subjects were divided into three groups: without osteoporosis, with osteopenia and with osteoporosis. In all men the serum level of the following was marked: 1) 3 markers of bone formation: osteocalcin (BGP), bone alkaline phosphatase (b-ALP) and Procollagen I Aminoterminal propeptide (PINP); 2) 2 markers of bone resorption: Collagen Type I Crosslinked C-telopeptide (Ctx) and Tartarate Resistant Acid Phosphatase (TRAP); 3) testosterone. The results obtained were subjected to thorough statistical analisis. Mean concentrations of bone metabolism, testosterone and calcium consumption in the groups examined were compared by mean of ANOVA variance analysis and the smallest significant difference test. Relationship between markers of bone resorption and formation, testosterone level and bone mineral density (BMD) were shown by means of Pearson linear correlation. The relevance of markers in the diagnosing of osteoporosis in men was evaluated by means of the ROC curves. The results obtained lead to the following conclusions: Among the markers of bone turnover analysed, Collagen Typ I Crosslinked C-telopeptide (Ctx-serum) is the most useful marker in the diagnosis of osteoporosis in men, followed by Tartarate Resistant Acid Phosphatase (TRAP) and osteocalcin (BGP). There is no relationship between bone mineral density and serum testosterone level.