[Pathogenesis, diagnosis and treatment of osteoporosis in men]

Osteoporosis traditionally is connected with women health, although recently has received increasing attention as one of the most important disorders in men. Lifetime risk of any fragility fracture in men has been estimated to 15-25% compared with about 50% in women. Less than one third of all nonvertebral fractures and about 15% vertebral fractures occur in men. However mortality connected with hip fractures in men is approximately 3-hold higher than in women. The principles factors that are necessary to obtain and maintain proper bone mineral density in men, besides genetic factors, are sex hormone - testosterone and also estrogens. The rarely occurrence of male osteoporosis is associated with increased peak bone mass and bone strength mainly due to periosteal expansion, and also with lack of phase of accelerated bone loss. Currently aminobisphosphonate (alendronate) and recombined human parathormone (rhPTH) has been proved to reduced fracture risk in men. In men with osteoporosis and late-onset hypogonadism (LOH) increasing of bone mineral density after testosterone replacement therapy was observed, but influence of this treatment on fracture risk is still unknown. As a general rule, men with osteoporosis should receive adequate calcium (1200-1500 mg/day) and vitamin D/alfacalcidol supplementation,