Loures Marco Antônio R, Zerbini Cristiano Augusto F, Danowski Jaime S, Pereira Rosa Maria R, Moreira Caio, Paula Ana Patrícia de, Castro Charlles Heldan M, Szejnfeld Vera Lúcia, Mendonça Laura Maria C, Radominiski Sebastião C, Bezerra Mailze C, Simões Ricardo, Bernardo Wanderley M
Sociedade Brasileira de Reumatologia (SBR), Comissão de Doenças Osteometabólicas e Osteoporose, São Paulo, SP, Brazil; Universidade Estadual de Maringá (UEM), Hospital Universitário, Maringá, PR, Brazil.
Sociedade Brasileira de Reumatologia (SBR), Comissão de Doenças Osteometabólicas e Osteoporose, São Paulo, SP, Brazil; Centro Paulista de Investigação Clínica (CEPIC), São Paulo, SP, Brazil.
Rev Bras Reumatol Engl Ed. 2017;57 Suppl 2:497-514. doi: 10.1016/j.rbre.2017.07.003. Epub 2017 Aug 8.
Osteoporosis, a metabolic disease characterized by low bone mass, deterioration of the bone tissue microarchitecture and increased susceptibility to fractures, is commonly regarded as a women's health problem. This point of view is based on the fact that compared with men, women have lower bone mineral density and longer lifespans and lose bone mass faster, especially after menopause, due to a marked decrease in serum estrogen levels. However, in the last 20 years, osteoporosis in men has become recognized as a public health problem due to the occurrence of an increasingly higher number of fragility fractures. Approximately 30% of all hip fractures occur in men. Recent studies show that the probability of fracture due to hip, vertebral or wrist fragility in Caucasian men older than fifty years, for the rest of their lives, is approximately 13% versus a 40% probability of fragility fractures in women. Men show bone mass loss and fractures later than women. Although older men have a higher risk of fracture, approximately half of all hip fractures occur before the age of 80. Life expectancy is increasing for both sexes in Brazil and worldwide, albeit at a higher rate for men than for women. This Guideline was based on a systematic review of the literature on the prevalence, etiology, diagnosis and treatment of osteoporosis in men.
骨质疏松症是一种代谢性疾病，其特征为骨量低、骨组织微结构破坏以及骨折易感性增加，通常被视为女性健康问题。这种观点基于这样一个事实，即与男性相比，女性骨矿物质密度较低、寿命较长且骨质流失更快，尤其是在绝经后，这是由于血清雌激素水平显著下降所致。然而，在过去20年里，由于脆性骨折的发生率越来越高，男性骨质疏松症已被公认为一个公共卫生问题。所有髋部骨折中约30%发生在男性身上。最近的研究表明，50岁以上的白种男性因髋部、脊椎或腕部脆性骨折而在余生发生骨折的概率约为13%，而女性脆性骨折的概率为40%。男性骨质流失和骨折的时间比女性晚。尽管老年男性骨折风险较高，但所有髋部骨折中约一半发生在80岁之前。在巴西和全球，男女的预期寿命都在增加，不过男性的增速高于女性。本指南基于对有关男性骨质疏松症的患病率、病因、诊断和治疗的文献进行的系统综述。
