When Should Men Be Tested for Osteoporosis?

Male osteoporosis is more common than most people believe, with men over 50 being at greater risk of osteoporosis-related fracture than they are for prostate cancer. Until the prevalence of male osteoporosis is better known, however, bone-density screening for men 50 and under is not currently recommended.

While the causes of male osteoporosis are not yet well understood, the greatest risk is in men who have a parent with osteoporosis, have kidney stones, have pituitary problems, or have been treated with glucocorticoids. Men who have kidney stones are at high risk. Secondary risk factors are alcohol, smoking, and malnourishment. Among Caucasian men 65 and older, about 80% of hip fractures will be attributed to osteoporosis. Mortality in men one year after a hip fracture is nearly twice as high as it is for women.

Men over 50 who complain of unexplained back pain or other secondary causes, such as a history of kidney stones, alcoholism, and steroids usage, should be screened with bone density testing. Men over 55 should also be screened who have inexplicably lost two or more inches in height or have sustained a fracture during adult life. After diagnosis, underlying factors such as diet and the intake of calcium and vitamin D should be improved.

This update on male osteoporosis was presented at the annual meeting of the American Association of Clinical Chemistry in Philadelphia (PA, USA) by Clifford J. Rosen, M.D., affiliated with St. Joseph Hospital (Bangor, ME, USA) and director of the Maine Center for Osteoporosis Research and Education.




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