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A prospective, observational study of osteoporosis in men
oleh: Narendra Kotwal, Vimal Upreti, Amit Nachankar, K V. S Hari Kumar
Format: | Article |
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Diterbitkan: | Wolters Kluwer Medknow Publications 2018-01-01 |
Deskripsi
Context: The number of men afflicted with osteoporosis is unknown. Aims: This study aims to determine the prevalence of osteoporosis in men. Settings and Design: This was a prospective, observational study. Subjects and Methods: A total of 200 male attendants of patients attending endocrine outpatient department and who were >55 years were recruited for the study. All the patients with osteopenia and osteoporosis were advised lifestyle interventions, supplementation with calcium carbonate (1000–1500 mg/day) and 25-hydroxyl-Vitamin D (400–600 IU/day) and bisphosphonates if indicated. Vitamin D3 60,000 IU once a week for 8 weeks and once a month thereafter was prescribed to Vitamin D-deficient patients. Androgen-deficient patients were given replacements of either injectable testosterone or oral testosterone undecanoate. Statistical Analysis Used: Two sample t-test and paired t-test were used to compare pre- and post-test parameters. Results: Overall 80 (40%) subjects had low bone mass, 93 (43.5%) had Vitamin D deficiency/insufficiency, and 39 (19.5%) had androgen deficiency. Osteoporosis was found in 8.5% patients. All patients were above 70 years (Mean age: 73.82 ± 2.79 years). Seventy percentage of these patients had low serum testosterone and 70% of patients had Vitamin D deficiency/insufficiency. About 31.5% of patients had osteopenia (mean age of 67.47 ± 6.35 years). Thirty-five percentage of these patients were androgen deficient and 25% were Vitamin D-deficient/insufficient. Age >70 years, serum testosterone <3 ng/ml, Vitamin D <30 ng/ml were strong risk factors for osteoporosis. Vitamin D supplementation, androgen replacement, and bisphosphonate therapy had beneficial effect on bone mineral density (BMD). Conclusions: Low bone mass was common (40%) in males over 55 years of age. Age >70 years, low androgen (<3 ng/ml), steroid use, and low Vitamin D (<20 ng/ml) were independent risk factors of male osteoporosis. Calcium and Vitamin D are effective in improving BMD. Androgen replacement has beneficial effect on BMD in hypogonadism patients.