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Update on male osteoporosis

机译：男性骨质疏松的最新动态

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PURPOSE: Fragility fractures are increasingly recognized as an important cause of morbidity and mortality in men. This review focuses on the potential causes, means of diagnosis, and available treatment for male osteoporosis. EPIDEMIOLOGY: More than 2 million men in the United States have osteoporosis, and approximately 1 in 5 fractures occur in men. Moreover, it is estimated that there will be 800 000 hip fractures in men worldwide in 2025, reflecting a greater rate of increase in men (89%) than that in women (69%). REVIEW SUMMARY: Male osteoporosis is a multifactorial disorder with testosterone deficiency, excessive glucocorticoids, and excess alcohol intake the most commonly observed causes. Although the lifetime risk of fracture is lower in men than in women, men have higher mortality rates after hip and other types of osteoporotic fracture. Diagnostic assessment of osteoporosis in men generally should be more comprehensive than that in women, given that more than half of men will have an identifiable secondary disorder that contributes to their disease. Treatment with pharmacologic agents does have favorable effects on bone mineral density in men, though definitive evidence of antifracture benefit is lacking to date. TYPE OF AVAILABLE EVIDENCE: Systematic reviews, prospective cohort studies, randomized-controlled trials, meta-analyses. GRADE OF AVAILABLE EVIDENCE: Fair. CONCLUSION: Male osteoporosis is a common disorder associated with significant morbidity and mortality. An approach of lifestyle modification, appropriate nutrition (with calcium/vitamin D), and selective use of pharmacologic agents appears to confer skeletal benefit to men similar to that in women.
机译：目的：脆弱性骨折越来越被认为是男性发病和死亡的重要原因。这篇综述着重于男性骨质疏松症的潜在原因，诊断方法和可用治疗方法。流行病学：美国有超过200万男性患有骨质疏松症，男性中约有五分之一骨折。此外，据估计，到2025年，全球男性将有80万髋部骨折，反映出男性（89％）的增幅高于女性（69％）的增幅。综述：男性骨质疏松是一种多因素疾病，最常见的原因是睾丸激素缺乏，糖皮质激素过多和酒精摄入过多。尽管男性的一生骨折风险比女性低，但是男性在髋部和其他类型的骨质疏松性骨折后的死亡率较高。鉴于超过一半的男性患有可识别的导致其疾病的继发性疾病，因此男性的骨质疏松症的诊断评估通常应比女性更全面。尽管迄今为止尚无明确的抗骨折益处证据，但使用药物治疗对男性的骨矿物质密度确实具有有利的影响。可用证据的类型：系统评价，前瞻性队列研究，随机对照试验，荟萃分析。可用的证据等级：公平。结论：男性骨质疏松是一种常见的疾病，与高发病率和高死亡率相关。改变生活方式，适当营养（含钙/维生素D）和选择性使用药理学的方法似乎可以给男性带来类似于女性的骨骼益处。

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