De Martinis Massimo, Sirufo Maria Maddalena, Polsinelli Matteo, Placidi Giuseppe, Di Silvestre Daniela, Ginaldi Lia
Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Allergy and Clinical Immunology Unit, Center for the Diagnosis and Treatment of Osteoporosis, Teramo, Italy.
World J Mens Health. 2021 Oct;39(4):750-759. doi: 10.5534/wjmh.200099. Epub 2020 Nov 26.
Osteoporosis affects more than 200 million people worldwide: its prevalence increases with age and is actually growing due to the constant population aging. Women are at greater risk than men, but in recent years it has become increasingly evident that osteoporosis represents a significantly important problem also for men. However, osteoporosis in men is still poorly studied, underdiagnosed and inadequately treated.
We conducted an observational study to identify any gender disparities in osteoporosis screening. For this purpose we observed people consecutively admitted at our Outpatient Service for the Diagnosis of Osteoporosis during the last 3 years. Patients underwent clinical and laboratory assessment and bone mineral density (BMD) measurements by dual-energy X-ray absorptiometry. Bone turnover serum markers have been evaluated and stratified according to gender.
Out of 3,752 patients, 2,376 subjects who met the inclusion criteria were identified. As expected, the great majority (94.5%) of the screened subjects were women and only 5.4% were men. Women exhibited lower BMD compared to men (T-score values: -2.33±1.14 -1.31±1.55; p<0.001), whereas the prevalence of fractures in osteoporotic men was significantly higher (50% 31%; p<0.001). Women had lower vitamin D and higher bone remodeling markers compared to men. Secondary osteoporosis was more frequent in men (66.67%) than in women (20.83%) and the calculated risk for hip fractures was higher in osteoporotic men compared to women (11.47±10.62 6.87±7.73; p<0.001).
Here we highlighted that men are under-screened for osteoporosis and exhibit secondary osteoporosis more frequently than women.
骨质疏松症影响着全球超过2亿人：其患病率随年龄增长而上升，并且由于人口持续老龄化，实际上还在增加。女性比男性面临更大风险，但近年来越来越明显的是，骨质疏松症对男性来说也是一个极其重要的问题。然而，男性骨质疏松症仍研究不足、诊断不足且治疗不充分。
我们进行了一项观察性研究，以确定骨质疏松症筛查中是否存在性别差异。为此，我们观察了过去3年连续在我们门诊骨质疏松症诊断服务中心就诊的患者。患者接受了临床和实验室评估以及通过双能X线吸收法进行的骨密度（BMD）测量。对骨转换血清标志物进行了评估并按性别分层。
在3752名患者中，确定了2376名符合纳入标准的受试者。正如预期的那样，筛查对象中的绝大多数（94.5%）是女性，只有5.4%是男性。与男性相比，女性的骨密度较低（T值：-2.33±1.14对-1.31±1.55；p<0.001），而骨质疏松男性的骨折患病率显著更高（50%对31%；p<0.001）。与男性相比，女性的维生素D水平较低，骨重塑标志物较高。继发性骨质疏松症在男性中（66.67%）比在女性中（20.83%）更常见，并且骨质疏松男性髋部骨折的计算风险高于女性（11.47±10.62对6.87±7.73；p<0.001）。
我们在此强调，男性在骨质疏松症筛查方面不足，并且比女性更频繁地表现出继发性骨质疏松症。
