Management of Osteoporosis in Men: A Narrative Review

International Journal of Molecular Sciences

Roberto Cesareo¹  Luca Giovanelli²  Luigi Gennari³  Francesco Bertoldo⁴  Martina Brigo⁴  Fabio Vescini⁵  Antonio Stefano Salcuni⁵  Alberto Falchetti⁶  Iacopo Chiodini⁶  Stefania Bonadonna⁶  Andrea Palermo⁷  Alfredo Scillitani⁸  Vincenzo De Geronimo⁹ 

[1] Center of Metabolic Disease, S.M. Goretti Hospital, 04100 Latina, Italy;Department of Medical Biotechnology and Translational Medicine, University of Milan, 20122 Milan, Italy;Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy;Department of Medicine, University of Verona, 37129 Verona, Italy;Endocrinology and Metabolism Unit, University-Hospital S. Maria della Misericordia, 33100 Udine, Italy;Istituto Auxologico Italiano, IRCCS, 20149 Milan, Italy;Unit of Endocrinology and Diabetes, Campus Bio-Medico University, 00128 Rome, Italy;Unit of Endocrinology, Ospedale “Casa Sollievo della Sofferenza”, IRCCS, San Giovanni Rotondo, 71013 Foggia, Italy;Unit of Endocrinology—Policlinico Morgagni CCD, 95125 Catania, Italy;

关键词: osteoporosis;    BMD;    male;    bone fragility;    fractures;    DXA;   

DOI  :  10.3390/ijms222413640

来源: DOAJ

【 摘 要 】

Male osteoporosis is a still largely underdiagnosed pathological condition. As a consequence, bone fragility in men remains undertreated mainly due to the low screening frequency and to controversies in the bone mineral density (BMD) testing standards. Up to the 40% of overall osteoporotic fractures affect men, in spite of the fact that women have a significant higher prevalence of osteoporosis. In addition, in males, hip fractures are associated with increased morbidity and mortality as compared to women. Importantly, male fractures occur about 10 years later in life than women, and, therefore, due to the advanced age, men may have more comorbidities and, consequently, their mortality is about twice the rate in women. Gender differences, which begin during puberty, lead to wider bones in males as compared with females. In men, follicle-stimulating hormones, testosterone, estrogens, and sex hormone-binding levels, together with genetic factors, interact in determining the peak of bone mass, BMD maintenance, and lifetime decrease. As compared with women, men are more frequently affected by secondary osteoporosis. Therefore, in all osteoporotic men, a complete clinical history should be collected and a careful physical examination should be done, in order to find clues of a possible underlying diseases and, ultimately, to guide laboratory testing. Currently, the pharmacological therapy of male osteoporosis includes aminobisphosphonates, denosumab, and teriparatide. Hypogonadal patients may be treated with testosterone replacement therapy. Given that the fractures related to mortality are higher in men than in women, treating male subjects with osteoporosis is of the utmost importance in clinical practice, as it may impact on mortality even more than in women.

【 授权许可】

Unknown