January 31, 2007

Men warned of osteoporosis risk

Although osteoporosis has long been considered a woman's disease, Professor of Clinical Medicine Aliya A. Khan of McMaster University in Ontario warns that osteoporosis can severely afflict men as well, and wants physicians to realize that they can no longer overlook the disease in male patients. While a fourth of older women are estimated to have osteoporosis, one in eight men over the age of 50 has the disease, and one in three men die following a fracture compared to one in five women.

In a review published in the January 30, 2007 issue of the Canadian Medical Association Journal Dr Khan and her Canadian colleagues developed guidelines for the diagnosis, treatment and management of male osteoporosis, supplementing guidelines published by Osteoporosis Canada in 2002 with information from the current literature. The review identifies primary risk factors such as advancing age, previous fragility fractures and long term glucocorticoid therapy, and secondary causes such as hyperparathyroidism, vitamin D inadequacy, and increased urinary excretion of calcium. Bone mineral density testing for all men over 65 and younger men with osteoporosis risk factors is recommended, as well as long term monitoring of height to detect compression fractures of the spine.

Treatment options earning an "A" in the 2002 Osteoporosis Canada Guidelines are bisphosphonate drugs and 800 international units or more per day vitamin D.

Dr Kahn noted that researchers are "just at the tip of the iceberg" in their understanding of osteoporosis in men compared to their knowledge of how the disease affects women and how to treat it. "The problem is that when men sustain fractures they are more likely to die or suffer a disability," she observed.

In summarizing the researchers' goal, Dr Kahn stated "We want to bring all the research we have to the forefront and we want to bring it to the desk of Canadian physicians."