Male osteoporosis

Abstract

Osteoporosis, a disease classically attributed to postmenopausal women, is underappreciated, underdiagnosed, and undertreated in men. However, it is not uncommon for osteoporotic fractures to occur in men. About 40% of fractures occur in men with an incidence that has increased over the years. After a first fracture, the risk of a subsequent episode, as well as the risk of death, is higher in the male than in the female population. Despite these facts, only 10% of men with osteoporosis receive adequate treatment. Up to half of the cases of male osteoporosis have a secondary cause, the most common being hypogonadism, excessive alcohol consumption, and chronic use of glucocorticoids. The International Society for Clinical Densitometry (ISCD) recommends using the female database for the diagnosis of osteoporosis by DXA (T-score ≤ -2.5 in men over 50 years old). In addition, osteoporosis can also be diagnosed independently of the BMD if a fragility fracture is present, or if there is a high risk of fractures by FRAX. Treatment is similar to postmenopausal osteoporosis, because the data regarding changes in bone density track closely to those in women. Data concerning fracture risk reduction are not as certain because the clinical trials have included fewer subjects for shorter period of time. In men with symptomatic hypogonadism, testosterone replacement, if indicated, can improve BMD.

Opportunistic Identification of Vertebral Compression Fractures on CT Scans of the Chest and Abdomen, Using an AI Algorithm, in a Real-Life Setting

“…In our study, 48% of patients in the retrospective cohort had known osteoporosis at baseline; of these 74.4% were women. This is anticipated due to the higher incidence of osteoporosis in women and the tendency for osteoporosis in men to go unnoticed [ 32 , 33 ]. Many studies have evaluated incident findings of VCF on chest radiographs or CTAB, but few studies report on patients’ osteoporosis- and treatment status at the time of identification.…”

Integration of bioinformatics and machine learning approaches for the validation of pyrimidine metabolism-related genes and their implications in immunotherapy for osteoporosis

“…Termed the ‘silent epidemic of the twenty-first century,’ osteoporosis has become a paramount public health concern, representing the most common metabolic bone disorder [ 2 ]. It is chronic, progressively severe, and typically silent until the occurrence of the first fracture, placing it fourth among chronic diseases after cardiovascular diseases, dementia, and lung cancer, and highlighting its profound societal and economic impact [ 3 , 4 ]. This asymptomatic nature often leads to delayed diagnoses, emphasizing the urgent need for the early detection and intervention biomarkers [ 5 ].…”