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Title: Bone fragility in men--where are we?
Austin Authors: Seeman, Ego ;Bianchi, G;Khosla, S;Kanis, J A;Orwoll, E
Affiliation: Austin Health, Centaur Building, Repatriation Campus, Heidelberg, 3082, Melbourne, Australia
Issue Date: 1-Aug-2006
Publication information: Osteoporosis International : A Journal Established As Result of Cooperation Between the European Foundation For Osteoporosis and the National Osteoporosis Foundation of The Usa 2006; 17(11): 1577-83
Abstract: This is a summary of several aspects of the epidemiology, pathogenesis and treatment arising directly and indirectly from the proceedings of the Third International Osteoporosis in Men meeting held in Genoa in May 2005. Advances in the study of bone fragility in men have taken place, but many challenges remain.Although the epidemiology of hip fractures is well documented, the epidemiology of other non-vertebral fractures is less well defined even though these fractures contribute substantially to the global burden of fractures in men. The epidemiology of vertebral fragility fractures is derived mostly from cross sectional data. The comparable prevalence of vertebral fractures in men and women is likely to be misleading because of traumatic vertebral fractures that arise in young men. Prospective studies are needed to define the proportion of these fractures that are traumatic. After the age of 50 years, the incidence of vertebral fractures in men is about one third to one half of that in women. As in women, most vertebral and non-vertebral fragility fractures occur in persons without osteoporosis. Identifying these individuals is an unmet challenge. The absolute risk for fractures appears no different by sex in men and women of the same age and bone mineral density (BMD) so that the diagnostic threshold for osteoporosis in women can be used in men. Fracture risk varies around the world and is unlikely to be explained solely by variations in BMD, though there are few data comparing men and women of different races. Both the notion that men lose less bone than women from the endosteal envelope and that they gain more on the periosteal envelope during advancing age needs reassessment as recent evidence challenges these observations. Sex differences in the net gain and loss from these surfaces are likely to be site specific, and research is needed to specify this heterogeneity and the reasons for it. The independent and co-dependent effects of sex hormones and the growth hormone/insulin like growth factor 1 axis on periosteal and endosteal modeling and remodeling during growth as well as ageing are poorly defined. The anti-fracture efficacy and safety of androgens and other agents remain incompletely investigated in men.A great deal of research is needed to advance our understanding of bone fragility in men.
Gov't Doc #: 16896511
DOI: 10.1007/s00198-006-0160-8
Journal: Osteoporosis International
Type: Journal Article
Subjects: Aged
Aged, 80 and over
Fractures, Bone.epidemiology.etiology.prevention & control
Gonadal Steroid Hormones.physiology
Middle Aged
Sex Distribution
Appears in Collections:Journal articles

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