Rheumatology Unit, University of Verona, Pz Scuro 10, 37134, Verona, Italy.
Orthopedic Unit, University of Verona, Verona, Italy.
Arch Osteoporos. 2021 Mar 15;16(1):56. doi: 10.1007/s11657-021-00915-8.
In the present observational cohort study in 4902 men and 9804 women, we found that the factors associated with osteoporosis care utilization in men were comorbidities, adjuvant hormonal therapy for prostate cancer, vertebral or hip fractures, and glucocorticoid treatment.
Male osteoporosis is associated with an important clinical and economic burden worldwide; nevertheless, undertreatment of men with osteoporosis is common. Understanding the factors associated with referral to bone specialists may help to define future interventions to improve access to osteoporosis care for male patients.
We conducted a retrospective analysis of a nationwide cohort (DeFRACalc79 database). DeFRACalc79 is a tool that estimates the fracture risk by considering clinical and densitometric risk factors, including the presence of prior hip or vertebral and non-vertebral or non-hip fractures. We compared the clinical characteristics of male individuals with an age-matched cohort of women. Propensity score generation with a 2:1 female-to-male ratio was performed using a logistic regression model to age-match the cohorts.
We analyzed a sample of 4902 men at high risk for osteoporosis. We found that the factors associated with osteoporosis care utilization in men were the presence of comorbidities (OR 1.939, 95% CI 1.799-2.090), adjuvant hormonal therapy for prostate cancer (OR 1.482, 95% CI 1.315-1.670), the presence of vertebral or hip fractures (OR 1.490, 95% CI 1.378-1.611), and glucocorticoid treatment (OR 2.573, 95% CI 2.274-2.832).
Men are more commonly referred to the bone specialist with a prevalent fragility fracture and/or diagnosis of secondary osteoporosis as compared with women. Our study suggests that there is a lack of screening for the primary prevention of osteoporosis in men as compared with that in women.
在这项纳入 4902 名男性和 9804 名女性的观察性队列研究中，我们发现与男性骨质疏松症治疗相关的因素包括合并症、前列腺癌辅助激素治疗、椎体或髋部骨折以及糖皮质激素治疗。
男性骨质疏松症在全球范围内与重要的临床和经济负担相关；然而，男性骨质疏松症的治疗不足较为常见。了解与转介至骨科专家相关的因素可能有助于确定未来改善男性患者获得骨质疏松症治疗的干预措施。
我们对一个全国性队列（DeFRACalc79 数据库）进行了回顾性分析。DeFRACalc79 是一种通过考虑临床和骨密度计危险因素（包括既往髋部或椎体及非椎体或非髋部骨折）来估计骨折风险的工具。我们比较了男性个体与年龄匹配的女性队列的临床特征。使用逻辑回归模型进行倾向评分生成，采用 2:1 的女性对男性比例进行年龄匹配。
我们分析了一个有骨质疏松症高风险的 4902 名男性样本。我们发现，男性骨质疏松症治疗相关的因素包括合并症（OR 1.939，95%CI 1.799-2.090）、前列腺癌辅助激素治疗（OR 1.482，95%CI 1.315-1.670）、椎体或髋部骨折（OR 1.490，95%CI 1.378-1.611）和糖皮质激素治疗（OR 2.573，95%CI 2.274-2.832）。
与女性相比，男性更常因常见脆性骨折和/或继发性骨质疏松症诊断而被转介至骨科专家处。我们的研究表明，与女性相比，男性骨质疏松症的初级预防筛查不足。
