veNTIlATIoN - Green Cross Publishing

fOCUs On: OsTeOpOrOsis
Update on male osteoporosis
Khosla s
Journal
of Clinical
Endocrinology
and
Metabolism
2010 Jan; 95
(1): 3-10
abstracts
Osteoporosis in men is becoming an increasingly important public health problem. One in five men over the
age of 50 years will suffer an osteoporotic fracture during their lifetime, and men who sustain fractures have an
increased mortality risk.
Evidence for this American study from the College of Medicine, Mayo Clinic, Rochester, Minnesota, was
obtained by PubMed search and the author’s knowledge of the field.
Studies using computed quantitative tomography and high-resolution peripheral computed quantitative
tomography have provided new insights into the bone structural changes with aging in men, including the
somewhat surprising demonstration of significant, ongoing trabecular bone loss starting in young adult life. In
addition, there are now data demonstrating that serum oestradiol levels are important predictors of fracture
risk in men and that there is a threshold oestradiol level below which not only bone loss but also fracture risk
increases markedly.
Criteria for diagnosing and managing osteoporosis in men are also evolving, including the application of
the fracture risk assessment tool to derive 10-year fracture risks in men. Three bisphosphonates (alendronate,
risedronate and zoledronic acid) and teriparatide are currently US Food and Drug Administration approved for
the treatment of osteoporosis in men, with a number of new compounds, including a monoclonal antibody
against receptor activator of nuclear factor-kappaB ligand, selective oestrogen receptor modulators and
selective androgen receptor modulators in varying stages of development.
Despite significant advances, there remain a number of key unresolved issues regarding the pathogenesis
and management of male osteoporosis, not the least of which is increasing public awareness of this important
cause of morbidity and mortality in men.
The value of calcaneal bone mass measurement using a dual
X-ray laser Calscan device in risk screening for osteoporosis
Kayalar g,
cevikol A,
yavuzer g
et al
Clinics (Sao
Paulo) 2009; 64
(8): 757-62
The objective of this Turkish study from the Ministry of Health, Educational and Research Hospital PMR Clinic,
Ankara, was to evaluate how bone mineral density in the calcaneus measured by a dual-energy x-ray laser
(DxL) correlates with bone mineral density in the spine and hip in Turkish women over 40 years of age and to
determine whether calcaneal DxL variables are associated with clinical risk factors to the same extent as axial
bone mineral density measurements obtained using dual-energy x-ray absorptiometry (DxA).
A total of 2,884 Turkish women, aged from 40-90 years and living in Ankara, were randomly selected.
Calcaneal bone mineral density was evaluated using a DxL Calscan device. Subjects exhibiting a calcaneal DxL
T-score < or = -2.5 received a referral for DxA of the spine and hip. Besides DxL measurements, all subjects
were questioned about their medical history and the most relevant risk factors for osteoporosis.
Using a T-score threshold of -2.5, which is recommended by the WHO, DxL calcaneal measurements showed
that 13 per cent of the subjects had osteoporosis, while another 56 per cent had osteopenia. The mean
calcaneal DxL T-score of postmenopausal subjects who were smokers with a positive history of fracture,
hormone replacement therapy (HRT), covered dressing style, lower educational level, no regular exercise
habits and low tea consumption was significantly lower than that obtained for the other group (p