Bone density and fracture risk in men

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Melton, III, L. Joseph¹; Atkinson, Elizabeth J.¹; O'Connor, Michael K.²; O'Fallon, W. Michael¹; Riggs, B. Lawrence³

Bone density and fracture risk in men

J Bone Miner Res. December 1998;13(12):1915-1923

©1998 American Society for Bone and Mineral Research

Affiliations

¹Department of Health Sciences Research, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A.

²Department of Diagnostic Radiology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A.

³Division of Endocrinology, Metabolism, Nutrition and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, U.S.A.
Abstract

We evaluated different definitions of osteoporosis in a population‐based sample of 348 men (age 22–90 years) compared with 351 women (age 21–93 years). Thirty‐six men (10%) and 46 women (13%) had a history of osteoporotic fracture (hip, spine, or distal forearm due to moderate trauma at ≥ age 35). In logistic regression analysis, osteoporotic fracture risk was associated with bone mineral density (BMD) at all sites (neck, trochanter, total hip, lumbar spine, and total wrist) in both genders (p < 0.001) except spinal BMD in men. After adjusting for age, total hip BMD was the strongest predictor of fracture risk in women (odds ratio [OR] per 1 SD decline, 2.4; 95% confidence interval [CI], 1.6–3.7), while wrist BMD was best in men (OR, 1.5; 95% CI, 1.1–2.0). Among men but not women, bone mineral apparent density (BMAD) was a better predictor of fracture than BMD (wrist BMAD OR, 1.7; 95% CI, 1.3–2.3). Hip BMD/BMAD decreased linearly from age 20 years onward in both genders, while spinal BMD/BMAD declined after age 40 in women but not in men. In both genders, total wrist BMD/BMAD decreased after age 50. By World Health Organization criteria, the age‐adjusted prevalence of osteoporosis at the hip, spine, or wrist was 35% among women ≥50 years of age. A similar approach (BMD > 2.5 SD below the young male mean) produced an osteoporosis prevalence rate in men ≥50 years of age of 19%. Thus, bone density predicts fracture risk in men as it does in women, and the prevalence of osteoporosis in men, using sex‐specific normal values, is substantial. These observations indicate a need for better prevention and treatment strategies for men.
Links

DOI: 10.1359/jbmr.1998.13.12.1915

PubMed: 9844110

WoS: 000077134300016
History

Received: 1997-12-18

Revised: 1998-07-8

Accepted: 1998-08-5

Online: 1998-12-1

Cited Works (10)

Year	Entry
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