[CLINICAL CHARACTERISTICS OF MALE PATIENTS WITH OSTEOPOROSIS REFERRED TO THE ENDOCRINE CLINIC OF A TERTIARY HOSPITAL].

INTRODUCTION

Osteoporosis in men is underdiagnosed and undertreated. The prevalence of male osteoporosis increases with age and it becomes a significant public health burden. Currently, there are a few clinical studies on male osteoporosis with limited knowledge of effective therapeutic options.

AIMS: Our study aimed to characterize men with osteoporosis in a referral metabolic clinic in Rabin Medical Center at the Beilinson Campus.

METHODS

In this study we retrospectively analyzed the medical records of 270 consecutive male patients with osteoporosis diagnosed and treated in our clinic during 2013.

RESULTS

A total of 270 of 1940 (14%) patients with osteoporosis in our clinic were males. The mean age of men with osteoporosis was 67.9 ± 13.6; 113 (40%) men suffered from osteoporotic fractures, 57 of them (51%) had vertebral fractures, 28 (25%) had more than one fracture. Osteoporotic fracture was the first presentation of osteoporosis in 82% of men with fractures (age of presentation 62.2 ± 14.5). Furthermore, 141 patients (52%) had vitamin D insufficiency (25OHD levels < 60 nmol/l, normal 75-250 nmol/l), and the mean level was 39.9±12.6 nmol/l. Secondary osteoporosis was identified in 166 (61%) men. The most common etiologies were chronic glucocorticoid treatment (45%), hypogonadism (36%), hypercalciuria (23.4%) and hyperparathyroidism (19%). Most men (223) received bisphosphonates as primary therapy and alendronate was the mostly commonly prescribed agent.

CONCLUSIONS

Osteoporosis in men usually remains an underdiagnosed disorder until an osteoporotic fracture occurs. Secondary causes for osteoporosis are commonly encountered, of which glucocorticoid treatment and hypogonadism are the most prevalent etiologies. Increasing awareness of osteoporosis in men may prevent the deleterious consequences of this disabling, yet treatable disease.