High prevalence and correlates of osteoporosis in men aged 50  years and over: A nationwide osteoporosis survey in Taiwan

Abstract

Aims Osteoporosis is one of the consequences of aging, and it remains underdiagnosed and undertreated; this study aimed to present the characteristics and prevalence of osteoporosis in elderly men by conducting a nationwide survey in Taiwan. Methods The participants were enrolled between 2008 and 2011, and bone mineral density (BMD) was measured via dual‐energy X‐ray absorptiometry for the hip (total), lumbar spine (L1‐4), and femoral neck (FN). Patients with rheumatoid arthritis, female patients, and those using steroids were excluded. Osteoporosis was defined as a T‐score at the FN of ≤−2.5. Results This study included 3734 men of mean age 70.0 ± 9.3 years, accounting for the prevalence of osteoporosis at 9.7%. Participants with osteoporosis had a significantly older age, lower body weight, shorter height and more previous fractures than those without osteoporosis. The mean BMD at FN was 0.534 ± 0.056 and 0.791 ± 0.115 (g/cm2) in participants with and without osteoporosis, respectively (P < 0.001). The FN and hip (total) BMD showed a significant negative correlation with age (r = −0.234, P < 0.001) and (r = −0.003, P < 0.001), respectively, but not at L1‐4 (r = 0.00, P = 0.540). A history of fracture is the most important risk factor associated with male osteoporosis (odds ratio, 2.50; 95% CI, 1.49‐4.21; P = 0.006). Conclusions The associated factors for male osteoporosis are aging, lower body weight, and a history of fracture; the BMDs at FN and hip (total), but not L1‐4, are inversely correlated with age. We recommend that BMD at the proximal femur be the preferred site to evaluate osteoporosis for elderly male subjects.

Global prevalence of osteoporosis among the world older adults: a comprehensive systematic review and meta-analysis

“…This increase may be related to a decrease in postmenopausal estrogen in women [ 13 ]. A history of fractures is the most important risk factor for osteoporosis in men [ 15 ]. Men generally have more bone mass and content than women.…”

“…The prevalence of osteoporosis increases with age. People with osteoporosis were significantly older [ 13 , 15 , 21 , 62 , 63 ], had lower body weight, shorter height, and more previous fractures than people without osteoporosis [ 15 ]. The highest rate of bone loss occurs after the age of 65 [ 32 ].…”

“…The prevalence of osteoporosis among the elders in 2020 in Spain and China was reported to be 39.3% and 39.4%, respectively [ 12 , 13 ]. This amount was reported 49% in Nepal in 2019, 11% in Taiwan and 7.9% in Iran [ 9 , 14 , 15 ]. Female gender, age, marital status, history of peptic ulcer and fracture, and Osteoarthropathy are associated with osteoporosis in the elders [ 10 ].…”

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“…В исследовании NHANES (National Health And Nutrition Examination Survey) в общей популяции в возрастной группе от 70 до 79 лет распространенность остеопороза составила 16,4%, в возрастной группе 80 лет и старше достигала 26,2% [21]. В исследовании, проведенном среди мужчин в Тайване в возрасте 70±9,3 года, распространенность остеопороза составила 9,7% [22]. В то же время исследование в США в сходной возрастной группе (от 65 до 99 лет) продемонстрировало распространенность остеопороза до 24% [23].…”

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“…Based on an analysis of the Taiwan’s population-based National Health Insurance claims database, the prevalence of osteoporosis for males in 2013 was 1,400 and 6,227 per 100,000 persons in those aged 60–69 years and ≥80 years, respectively (Wang et al, 2017). A nationwide osteoporosis survey conducted in Taiwan reported that the prevalence of male osteoporosis was 9.7%, and the factors associated with male osteoporosis were aging, lower body weight, and a history of fracture (Ko et al, 2018). In Taiwan, osteoporosis in men is still underrecognized and undertreated.…”