Section of Endocrinology, Diabetes and Metabolism, Corporal Michael J. Crescenz VA Medical Center and Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, USA.
Section of Gastroenterology, Corporal Michael J. Crescenz VA Medical Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Osteoporos Int. 2024 Dec;35(12):2137-2144. doi: 10.1007/s00198-024-07236-9. Epub 2024 Sep 3.
Osteoporotic fracture has been understudied in men. In US male veterans aged 50 years and older between 2002 and 2019, hip fracture incidence increased between 2006 and 2019, fewer than 6% of men underwent DXA, and fewer than 0.5% of men were treated. Investigation of low screening and treatment rates is warranted.
In the United States, the annual incidence of osteoporotic hip fracture is estimated to be 250,000 to 300,000; the one-year mortality in some studies has been as high as 32%. Reports that hip fracture rates in US women 65 years and older may no longer be declining led to this investigation of hip fracture in men, a less studied population. We assessed the trends in the incidence of hip fracture in US male veterans 50 years and older of age as well as the rates of diagnosis and treatment in such men.
We assessed the recent trends of hip fracture incidence in a nation-wide male veteran population 50 years and older of age. Using data from the US Veterans Affairs Informatics and Computing Infrastructure (VINCI) 2002-2019, we calculated the annual age-standardized hip fracture incidence. Secondary objectives included evaluating the annual proportion of hip fracture patients who underwent dual-energy X-ray absorptiometry (DXA) before or after the fracture and/or received osteoporosis medication after the hip fracture over the study period.
Hip fracture incidence increased in male veterans from 2006 to 2019. Fewer than 6% of men underwent a DXA scan and fewer than 0.5% received osteoporosis medications up to two years after a hip fracture.
Despite available screening methods such as DXAs and medications for primary and secondary prevention of osteoporotic fractures, hip fracture incidence is not decreasing in older male veterans. Our study highlights a need for closer attention to fracture risk in men.
骨质疏松性骨折在男性中研究较少。在 2002 年至 2019 年间，年龄在 50 岁及以上的美国男性退伍军人中，髋部骨折的发病率在 2006 年至 2019 年间有所上升，不到 6%的男性接受了双能 X 线吸收法（DXA）检查，不到 0.5%的男性接受了治疗。有必要调查低筛查和治疗率的原因。
在美国，估计每年有 25 万至 30 万例骨质疏松性髋部骨折；一些研究的一年死亡率高达 32%。有报道称，美国 65 岁及以上女性的髋部骨折发生率可能不再下降，这促使人们对男性这一研究较少的人群进行髋部骨折调查。我们评估了美国 50 岁及以上男性退伍军人髋部骨折发病率的趋势，以及这些男性的诊断和治疗率。
我们评估了一个全国范围内 50 岁及以上男性退伍军人髋部骨折发病率的近期趋势。使用来自美国退伍军人事务部信息学和计算基础设施（VINCI）2002-2019 年的数据，我们计算了每年年龄标准化的髋部骨折发病率。次要目标包括评估在研究期间，每年接受双能 X 线吸收法（DXA）检查的髋部骨折患者比例，以及在髋部骨折后接受骨质疏松症药物治疗的患者比例。
男性退伍军人的髋部骨折发病率从 2006 年到 2019 年上升。不到 6%的男性接受过 DXA 扫描，不到 0.5%的男性在髋部骨折后两年内接受过骨质疏松症药物治疗。
尽管有 DXA 和药物等可用的筛查方法用于骨质疏松性骨折的一级和二级预防，但老年男性退伍军人的髋部骨折发病率并未下降。我们的研究强调了需要更加关注男性的骨折风险。
