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Bone density and fracture risk in men

L J Melton1, E J Atkinson, M K O'Connor

  • 1Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
|December 9, 1998
PubMed
Summary

Osteoporosis risk is linked to bone density in both men and women. Men have a substantial prevalence of osteoporosis, indicating a need for improved prevention and treatment strategies.

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Area of Science:

  • Orthopedics
  • Gerontology
  • Endocrinology

Background:

  • Osteoporosis is a significant public health concern, characterized by low bone density and increased fracture risk.
  • Existing definitions and diagnostic criteria for osteoporosis may not fully capture the risk in all populations, particularly men.
  • Understanding sex-specific differences in bone density loss and fracture prediction is crucial for effective management.

Purpose of the Study:

  • To evaluate different definitions of osteoporosis in a population-based sample of men and women.
  • To compare the predictive value of bone mineral density (BMD) and bone mineral apparent density (BMAD) for osteoporotic fractures in both genders.
  • To determine the prevalence of osteoporosis in men and women using sex-specific criteria.

Main Methods:

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  • A population-based sample of 348 men and 351 women aged 21-93 years was analyzed.
  • Logistic regression was used to assess the association between BMD at various skeletal sites and osteoporotic fracture history.
  • BMD and BMAD were compared as predictors of fracture risk, and age-adjusted prevalence of osteoporosis was calculated using World Health Organization criteria and sex-specific normal values.

Main Results:

  • Osteoporotic fracture risk was associated with BMD at multiple sites in both genders, with spinal BMD being an exception in men.
  • Total hip BMD was the strongest predictor in women, while wrist BMD was the strongest in men.
  • BMAD was a better fracture predictor than BMD in men, and bone density declined with age in both genders, with specific patterns for hip, spine, and wrist.

Conclusions:

  • Bone density is a significant predictor of fracture risk in both men and women.
  • The prevalence of osteoporosis in men, using sex-specific normal values, is substantial, highlighting a need for targeted prevention and treatment.
  • Further research and clinical strategies are required to address osteoporosis in men effectively.