Quehaceres de Medicos

Osteoporosis is not just a significant health problem for women. It is also prevalent in aging men, yet the disease often goes undiagnosed or untreated until a bone fracture occurs, according to a paper published in the June 2006 issue of the Journal of the American Academy of Orthopaedic Surgeons. These fractures, which are treated primarily by orthopaedic surgeons, can play an important role in identifying men with osteoporosis so the disease also can be treated.
It is estimated that more than two million men in the United States have osteoporosis. According to the paper, which is an extensive review of the current literature on this disease, 30 percent of hip fractures occur in men, and those men have twice the mortality rate of women during the initial hospitalization and first post-fracture year. One third of men who suffer a hip fracture lose independence and must move into a nursing facility or a relative's home. With 77 million baby boomers aging, the prevention, diagnosis and treatment of men with osteoporosis is crucial to preventing these fragility fractures.
"Osteoporosis is not only a women's disease--men also lose bone density as they age," said author Vonda J. Wright, MD, assistant professor in the Department of Orthopaedic Surgery at the University of Pittsburgh, and a Sports Medicine and Shoulder Fellow at the Hospital for Special Surgery in New York. "But because many of us physicians don't realize how common osteoporosis can be in men, we don't always look for it when a male patient has suffered a fracture. The fracture gets treated but the underlying disease does not, so the patient continues to be at risk."
Osteoporosis is often considered a woman's disease because it is linked to a loss of estrogen that occurs during aging. Because women have higher levels of estrogen, most of the research on osteoporosis has been focused on them. However, men also undergo a loss of estrogen and other hormones that affect bone density, albeit more gradually than women.

Men who are most likely to have osteoporosis are those who are over the age of 75, have a low body-mass index, have lost more than 5 percent of their body weight during the previous four years, currently smoke and are physically inactive; at least 50 percent of the causes of osteoporosis in men can be traced to other diseases or lifestyle choices. Men are more likely than women to have osteoporosis secondary to an underlying disease or metabolic problem. There is also a genetic factor in osteoporosis. "If you are a man who notices that your father is losing height, or sustained a hip fracture from a standing position, he may have osteoporosis; therefore, you may have a greater chance of developing osteoporosis too," Dr. Wright explained. "Even if you don't have those symptoms yet, you should see your orthopaedic surgeon or internist to have your bone density checked so you can begin a program of treatment if necessary."