Nov
01
2003

Osteoporosis In Males Is Common

A new study from the University of Toronto/Ontario has shown that contrary to the conventional teaching ostoporosis is not only a problem in females, but also a problem in males. The Canadian Multicentre Osteoporosis Study (CaMos) showed according to the epidemiologist Natalia Diaz-Granados that in Canada 16% of all women above the age of 50 and 5% of men above the age of 50 developed osteoporosis.

In the past men were thought to be more or less immune to osteoporosis, but this is not so. The results of this study were presented recently at the annual meeting of the American Society for Bone and Mineral Research in Minneapolis. 1,768 of the 2,884 men who were recruited into CaMos were eligible for the study, because they had not taken oral corticosteroids for three months, and bone scans were taken to measure bone density of their upper femurs (upper thigh bones). 89 men (or 5% of the group of 1768) showed osteoporosis. The mean age of this group was 65 years ranging from 50 to 96.

The researchers studied the high risk factors in men with osteoporosis and found that they were remarkably similar to the risk factors in women with osteoporosis. I have summarized the findings here in tabular form.
The study also showed that for men hip fractures seem to be more lethal than for women as within a year after a hip fracture from osteoporosis more men die. If a physician sees a patient and notices 2 or more of the risk factors identified in the table above, a bone scan to screen for osteoporosis should be done.

Osteoporosis In Males Is Common

Osteoporosis In Males Is Common

There are many more unanswered questions with regard to life styles and nutritional information. It is not known from this study whether the men were physically less active and whether there was a higher alcohol abuse and /or nutritional dysbalance with associated vitamin deficiencies. The authors stated that future research will focus on these factors and on whether biphosphonates (alendronate or Fosamax) are as useful in men with osteoporosis as they are in women.

Risk factors for osteoporosis in men
Risk factor: Explanation:
weight less than normal this may point to poor nutrition, lack of calcium, vit. D etc.
older men bone loss occurs slowly with age, both in men and women
history of smoking smoking reduces blood supply to the nutritional vessels in the bone. This leads to less bone forming cells (osteoblasts)
family history of osteoporosis one or more genes code for osteoporosis. More research needed in this field to develop new medications
history of fracture beyond the age of 50 osteoporosis leads to brittle bones with more fractures. A fracture in this age group should make the physician suspicious of osteoporosis or a metabolic bone problem

Based on an article in The Medical Post, page 78, Oct. 14, 2003.

Link to a chapter of osteoporosis in my Net Health Book.

Last edited December 9, 2012

Jan
01
2003

Vertebroplasty And Kyphoplasty: Are These Procedures Safe?

These two orthopedic spinal reconstruction pocedures have become popular in the past few years. “Vertebroplasty” means doing a repair job on a damaged vertebral bone (spinal column bone). Originally this was developed for end stage cancer patients who had a single bone metastasis that led to a collapse of this vertebral bone. The difference in a good outcome of this procedure can mean the difference between being bedridden until death or walking and being active.

In a recent review of THE BACK LETTER (Vol.12, 12, Dec. 2002, Lippincott Williams & Wilkins), which critically reviews the literature regarding back pain and treatments, this procedure, even if successful, has not been researched long enough to be considered “standard therapy”. Many investigators report a success rate of 95% for compression fractures in patients with osteoporosis. But the FDA has warned that the bone cement that it used in this type of spinal surgery has never been properly investigaed for this application in non-cancer patients.

Nevertheless the technique of vertebroplasty has been clinically so impressive that those with severe kyphosis in the spine also wanted surgery. Kyphosis is a roundback in the mid spine area (thoracic spine) that can significantly interfere with normal posture, breathing action and cardiovascular functioning. Kyphoplasty is the procedure of repairing the curvature of the kyphosis, which consists usually of a series of several vertebral bodies with wedge shaped compression fractures in the thoracic spine. Often these patients are older and have osteoporosis.

Vertebroplasty And Kyphoplasty...Are These Procedures Safe...

Vertebroplasty And Kyphoplasty…Are These Procedures Safe…

THE BACK LETTER warns that the verdict on longterm follow-ups is not out. It may take a long time, even 10 to 15 years before this will become available as proper controlled studies have never been done. As the FDA link show, there can be serious life threatening complications from the procedure itself (spinal cord compression, respiratory arrest and death etc.). However, the longterm complications have not been reported properly as there is no longterm trial going on where the investigators would specifically concentrate on finding complications and untoward side-effects.

A well-designed multicenter trial regarding vertebroplasty and kyphoplasty is badly needed to answer these safety questions. Apparently efforts are on their way to attempt to do this.

Here is a link to my nethealthbook.com chapter on osteoporosis:

http://www.nethealthbook.com/articles/rheumatologicaldisease_osteoporosis.php

Last edited December 10, 2012

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