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Related Experiment Videos

Osteoporosis in men

E Seeman1

  • 1Department of Endocrinology, Austin and Repatriation Medical Centre, University of Melbourne, Heidelberg, Australia.

Bailliere'S Clinical Rheumatology
|August 1, 1997
PubMed
Summary

Hip fractures are a growing concern for elderly men, with higher mortality rates than in women. Understanding bone loss mechanisms in men is crucial for developing effective osteoporosis treatments.

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Area of Science:

  • Gerontology
  • Orthopedics
  • Endocrinology

Background:

  • Hip fractures represent a significant health burden in men, with higher mortality compared to women.
  • The incidence of hip and vertebral fractures in men is increasing, posing a growing public health challenge.
  • Bone fragility in men is influenced by factors like peak bone mass, bone loss patterns, and periosteal appositional growth.

Purpose of the Study:

  • To review the epidemiology and pathophysiology of bone loss and fragility in men.
  • To identify potential contributing factors to reduced bone mineral density (BMD) and increased fracture risk in aging men.
  • To discuss current understanding and potential therapeutic strategies for osteoporosis in men.

Main Methods:

  • Literature review of epidemiological data on hip, vertebral, and forearm fractures in men.
  • Analysis of age-related changes in bone structure, including trabecular and cortical bone.
  • Examination of hormonal influences (testosterone, androgens, growth hormone, IGF-1) on bone metabolism.

Main Results:

  • Men have higher peak bone mass but similar peak bone mineral density (BMD) compared to women.
  • Cortical bone loss is less pronounced in men due to reduced endocortical resorption and greater periosteal formation.
  • Bone fragility in men is lower due to larger bone size, less trabecular bone loss, and compensatory periosteal apposition.

Conclusions:

  • Reduced BMD in men with fractures may stem from lower peak bone size/mass and accelerated bone loss.
  • Age-related hormonal decline and conditions like hypogonadism contribute to bone loss in men.
  • While no definitive anti-fracture treatments exist for male osteoporosis, testosterone replacement and vitamin D correction are recommended, alongside calcium and bisphosphonates.

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