Rabijewski Michał, Papierska Lucyna, Zgliczyński Wojciech
Centrum Medycznego Kształcenia Podyplomowego w Warszawie, Klinika Endokrynologii.
Pol Merkur Lekarski. 2008 Jan;24(139):76-80.
Osteoporosis traditionally is connected with women health, although recently has received increasing attention as one of the most important disorders in men. Lifetime risk of any fragility fracture in men has been estimated to 15-25% compared with about 50% in women. Less than one third of all nonvertebral fractures and about 15% vertebral fractures occur in men. However mortality connected with hip fractures in men is approximately 3-hold higher than in women. The principles factors that are necessary to obtain and maintain proper bone mineral density in men, besides genetic factors, are sex hormone - testosterone and also estrogens. The rarely occurrence of male osteoporosis is associated with increased peak bone mass and bone strength mainly due to periosteal expansion, and also with lack of phase of accelerated bone loss. Currently aminobisphosphonate (alendronate) and recombined human parathormone (rhPTH) has been proved to reduced fracture risk in men. In men with osteoporosis and late-onset hypogonadism (LOH) increasing of bone mineral density after testosterone replacement therapy was observed, but influence of this treatment on fracture risk is still unknown. As a general rule, men with osteoporosis should receive adequate calcium (1200-1500 mg/day) and vitamin D/alfacalcidol supplementation,
传统上，骨质疏松症与女性健康相关，不过最近它作为男性最重要的疾病之一受到了越来越多的关注。据估计，男性发生任何脆性骨折的终生风险为15% - 25%，而女性约为50%。所有非椎体骨折中不到三分之一以及约15%的椎体骨折发生在男性身上。然而，男性髋部骨折相关的死亡率比女性高约3倍。除遗传因素外，男性获得和维持适当骨矿物质密度所需的主要因素是性激素——睾酮以及雌激素。男性骨质疏松症发生率低与骨峰值增加和骨强度增加有关，这主要归因于骨膜扩张，还与缺乏骨量加速流失阶段有关。目前已证实氨基双膦酸盐（阿仑膦酸盐）和重组人甲状旁腺激素（rhPTH）可降低男性骨折风险。在患有骨质疏松症和迟发性性腺功能减退（LOH）的男性中，观察到睾酮替代治疗后骨矿物质密度增加，但这种治疗对骨折风险的影响仍不清楚。一般来说，患有骨质疏松症的男性应补充足够的钙（1200 - 1500毫克/天）和维生素D/阿法骨化醇。
