Osteoporosis in men.

Osteoporosis in men is now recognized as an increasingly important public health issue. About 30 percent of hip fractures occur in men, and one in eight men older than 50 years will have an osteoporotic fracture. Because of their greater peak bone mass, men usually present with hip, vertebral body, or distal wrist fractures 10 years later than women. Hip fractures in men, however, result in a 31 percent mortality rate at one year after fracture versus a rate of 17 percent in women. Major risk factors for osteoporosis in men are glu- cocorticoid use for longer than six months, osteopenia seen on plain radiographs, a his- tory of nontraumatic fracture, hypogonadism, and advancing age. Bisphosphonates and teriparatide (recombinant parathyhroid hormone) have recently been approved for use in men and should be considered along with supplemental calcium and vitamin D. Increased awareness by physicians of risk factors for male osteoporosis—and early diag- nosis and treatment—are needed to decrease the morbidity and mortality resulting from osteoporotic fractures. (Am Fam Physician 2003;67:1521-6. Copyright© 2003 American Academy of Family Physicians.)