San Francisco Coordinating Center, California Pacific Medical Center Research Institute, 185 Berry Street, Lobby 5, Suite 5700, San Francisco, CA 94107-1762, USA.
Clin Orthop Relat Res. 2011 Jul;469(7):1900-5. doi: 10.1007/s11999-011-1780-7.
Osteoporosis is generally thought of as a "woman's disease" because the prevalence of osteoporosis and the rate of fractures are much higher in postmenopausal women than in older men. However, the absolute number of men affected by osteoporosis and fractures is large, as at least 2.8 million men in the United States are thought to have osteoporosis.
QUESTIONS/PURPOSES: The purposes of this review are to (1) highlight gender differences in osteoporosis and fracture risk, (2) describe disparities in treatment and outcomes after fractures between men and women, and (3) propose solutions to reducing disparities in treatment and prevention.
A literature survey was conducted using MEDLINE with a variety of search terms and using references from the author's personal collection of articles. A formal search strategy and exclusion criteria were not employed and the review is therefore selective. WHERE ARE WE NOW?: Postmenopausal women have a higher prevalence of osteoporosis and greater incidence of fracture than older men. Despite the higher fracture risk in postmenopausal women, older men tend to have worse outcomes after fracture and poorer treatment rates, although less is known about the disease course in men. Multifaceted interventions to improve the screening and treatment for osteoporosis were recently developed. WHERE DO WE NEED TO GO?: Improvement in treatment rates of those at risk, regardless of gender, is an important goal in osteoporosis management. HOW DO WE GET THERE?: Further development and evaluation of cost-effective, multifaceted interventions for screening and treatment of osteoporosis and fractures are needed; such interventions will likely improve the primary prevention of fractures.
骨质疏松症通常被认为是一种“女性疾病”，因为绝经后女性的骨质疏松症患病率和骨折率远高于老年男性。然而，受骨质疏松症和骨折影响的男性绝对数量庞大，据估计，美国至少有 280 万男性患有骨质疏松症。
问题/目的：本综述的目的是：(1) 强调骨质疏松症和骨折风险方面的性别差异；(2) 描述男性和女性骨折治疗和结局的差异；(3) 提出减少治疗和预防差异的解决方案。
使用 MEDLINE 进行文献调查，使用了多种搜索词，并使用作者个人收藏的文章作为参考。未采用正式的搜索策略和排除标准，因此该综述具有选择性。
我们现在在哪里？绝经后女性的骨质疏松症患病率和骨折发生率高于老年男性。尽管绝经后女性的骨折风险更高，但老年男性骨折后往往预后更差，治疗率更低，尽管关于男性疾病进程的了解较少。最近开发了多种干预措施来改善骨质疏松症的筛查和治疗。
我们需要去哪里？改善所有风险人群（无论性别）的治疗率是骨质疏松症管理的一个重要目标。
我们如何到达那里？需要进一步开发和评估针对骨质疏松症和骨折的具有成本效益的、多方面的筛查和治疗干预措施；此类干预措施可能会改善骨折的一级预防。
