Division of Endocrinology and Metabolism, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Osteoporos Int. 2011 Jun;22(6):1845-53. doi: 10.1007/s00198-010-1421-0. Epub 2010 Oct 9.
Evaluation of 234 men referred for osteoporosis found many with undiagnosed secondary causes and multiple unrecognized risk factors.
Studies in women with postmenopausal osteoporosis suggest that many have unrecognized disorders affecting bone. Men are considered more likely to have underlying, possibly correctable causes. We studied the prevalence of risk factors, secondary causes, and laboratory abnormalities in men with and without previously known causes for osteoporosis.
We reviewed the charts of 234 men with osteoporosis diagnosed by bone mineral density testing. In addition to screening chemistries, 25-hydroxyvitamin D, testosterone, luteinizing hormone, follicle-stimulating hormone, thyroid-stimulating hormone, and spot urinary calcium-to-creatinine ratio were measured.
The mean age was 70.6 years and mean weight was 76.4 kg. The mean T-score for spine, femoral neck, and forearm was -2.2, -2.4, and -2.3, respectively. Evaluation revealed secondary osteoporosis in 75% overall including hypogonadism, vitamin D deficiency, hypercalciuria, subclinical hyperthyroidism, and hyperparathyroidism. In those men with known secondary osteoporosis at the time of dual energy X-ray absorptiometry testing, additional diagnoses were found in just over half. Vitamin D deficiency and insufficiency were very common, and other common risk factors for osteoporosis included age >65, current smoking, and prior fracture. Half of the subjects had ≥ 4 risk factors.
Evaluation revealed a specific cause in about half of men thought to have primary osteoporosis. Among men with known secondary osteoporosis, additional risk factors and secondary causes were frequently identified. In conclusion, a relatively modest evaluation of men with osteoporosis will often provide useful information.
对 234 名因骨质疏松症而就诊的男性进行评估后发现，许多人患有未确诊的继发性病因和多种未被识别的危险因素。
对绝经后骨质疏松症女性的研究表明，许多人存在影响骨骼的未被识别的疾病。男性被认为更有可能存在潜在的、可能可纠正的病因。我们研究了有和没有已知骨质疏松症病因的男性中危险因素、继发性病因和实验室异常的发生率。
我们回顾了 234 名经骨密度检测诊断为骨质疏松症的男性患者的病历。除了筛查化学物质外，还测量了 25-羟维生素 D、睾酮、黄体生成素、卵泡刺激素、促甲状腺激素和尿钙/肌酐比值。
平均年龄为 70.6 岁，平均体重为 76.4 公斤。脊柱、股骨颈和前臂的平均 T 分数分别为-2.2、-2.4 和-2.3。评估结果显示，总体上有 75%的患者存在继发性骨质疏松症，包括性腺功能减退症、维生素 D 缺乏症、高钙尿症、亚临床甲状腺功能亢进症和甲状旁腺功能亢进症。在进行双能 X 线吸收仪检测时患有已知继发性骨质疏松症的男性中，仅发现一半以上的患者存在其他诊断。维生素 D 缺乏和不足非常常见，骨质疏松症的其他常见危险因素包括年龄>65 岁、当前吸烟和既往骨折。一半的患者有≥4 个危险因素。
对被认为患有原发性骨质疏松症的男性进行相对适度的评估后，通常会提供有用的信息。在已知患有继发性骨质疏松症的男性中，经常会发现其他危险因素和继发性病因。总之，对骨质疏松症男性进行相对适度的评估通常会提供有用的信息。
