Osteoporosis in Indian Males: Lumbar Spine DEXA Findings Among the Clinically Referred Cases

Osteoporosis in men is under-recognized despite substantial fracture-related morbidity. Indian evidence on biochemical correlates of male bone mineral density (BMD) is limited.

To estimate the burden of osteopenia/osteoporosis in adult males undergoing lumbar spine DEXA and to examine associations of serum 25-hydroxyvitamin D (25(OH)D) and total serum calcium with lumbar spine BMD.

A retrospective study was conducted at a tertiary hospital. From 426 de-identified DEXA records, 94 eligible males (≥20 years) with L1-L4 DEXA plus contemporaneous serum 25(OH)D and calcium (≤2 weeks) were included after excluding systemic disorders and therapies affecting bone metabolism. BMD categories followed the WHO T-score criteria. Analyses used chi-square, Pearson correlation, and multiple linear regression (SPSS v20.0; p<0.05).

Mean lumbar spine BMD was 0.96±0.21 g/cm²; mean 25(OH)D 18.32±13.62 ng/mL; mean calcium 8.70±2.18 mg/dL. Overall, 36.17% had osteopenia and 35.11% osteoporosis. Vitamin D deficiency (≤20 ng/mL) occurred in 67.02%, and hypocalcemia (<8.6 mg/dL) in 60.63%. BMD correlated positively with 25(OH)D (r=0.5910; p=0.0001) and calcium (r=0.6366; p=0.0001). In regression, both 25(OH)D (β=0.0091; p=0.0001) and calcium (β=0.0041; p=0.0001) independently associated BMD.

In clinically referred men, low lumbar spine BMD was frequent and closely linked to vitamin D and calcium status. Findings support combined DEXA and biochemical assessment for male osteoporosis risk stratification, with caution against generalising referral-based prevalence.