Medicus, Vol. 31 No. 2 Osteoporoza, 2022.
Review article
Osteoporosis in Men
Mirjana Kardum Pejić
Abstract
Osteoporosis is a progressive metabolic disease characterized by decreased bone mass and disruption of bone tissue microarchitecture. It results in increased bone fragility and likelihood of fractures. The most common clinical manifestations of the disease are vertebral and femoral neck fractures. As life expectancy increases, osteoporosis is becoming a rising issue in most developed countries. Osteoporotic fractures are becoming a common cause of mortality, disability, loss of an independent lifestyle and changes in quality of life. Due to the aging population, osteoporosis is one of the greatest causes of health crises in the developed world, with high costs that are likely to increase in the future. From a public health point of view, women are of greater interest than men because they live longer and have lower bone mineral density at every age overall compared to men. This, along with accelerated bone loss in the first years of menopause, contributes to a significantly higher risk of bone fractures. The mortality rate associated with hip fractures, as well as vertebral and other major fractures, is higher in men than in women. The diagnosis of idiopathic osteoporosis applies to men under 60 where there are no other possible causes of the disease. Their low bone mineral density (BMD) is mainly due to low peak bone mass. Roughly 40-60% of men have secondary osteoporosis, and involutional osteoporosis occurs in men over 60, as a result of decreased testosterone concentration and IGF-1. Current criteria for the diagnosis of osteoporosis in women can also be used in men. In terms of treatment, bisphosphonates, teriparatide and denosumab have been shown to increase BMD in males. The use of androgens has been shown to be effective in men with hypogonadism, but the justification of their use in eugonadal men is still a matter of debate.
Keywords
osteoporosis; osteoporotic fractures; men
Hrčak ID:
291562
URI
Publication date:
17.1.2023.
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