Campion Jant M, Maricic Michael J
Department of Medicine, University of Arizona Health Sciences Center, Tucson, Arizona 85724-5069, USA.
Am Fam Physician. 2003 Apr 1;67(7):1521-6.
Osteoporosis in men is now recognized as an increasingly important public health issue. About 30 percent of hip fractures occur in men, and one in eight men older than 50 years will have an osteoporotic fracture. Because of their greater peak bone mass, men usually present with hip, vertebral body, or distal wrist fractures 10 years later than women. Hip fractures in men, however, result in a 31 percent mortality rate at one year after fracture versus a rate of 17 percent in women. Major risk factors for osteoporosis in men are glucocorticoid use for longer than six months, osteopenia seen on plain radiographs, a history of nontraumatic fracture, hypogonadism, and advancing age. Bisphosphonates and teriparatide (recombinant parathyhroid hormone) have recently been approved for use in men and should be considered along with supplemental calcium and vitamin D. Increased awareness by physicians of risk factors for male osteoporosis--and early diagnosis and treatment--are needed to decrease the morbidity and mortality resulting from osteoporotic fractures.
男性骨质疏松症如今被视为一个日益重要的公共卫生问题。约30%的髋部骨折发生在男性身上,每8名50岁以上的男性中就有1人会发生骨质疏松性骨折。由于男性的峰值骨量更高,他们通常比女性晚10年出现髋部、椎体或远端腕部骨折。然而,男性髋部骨折在骨折后1年的死亡率为31%,而女性为17%。男性骨质疏松症的主要危险因素包括使用糖皮质激素超过6个月、X线平片显示骨质减少、非创伤性骨折病史、性腺功能减退以及年龄增长。双膦酸盐和特立帕肽(重组甲状旁腺激素)最近已被批准用于男性,应与补充钙和维生素D一起考虑。医生需要提高对男性骨质疏松症危险因素的认识,并进行早期诊断和治疗,以降低骨质疏松性骨折导致的发病率和死亡率。