Osteoporosis in men

With the prolongation of life expectancy, osteoporosis has become an increasing problem in the majority of developed countries worldwide. The paper discusses the frequency, pathogenesis, diagnostic criteria and treatment options for osteoporosis in men. Every third hip fracture occurs in men, and more than 11% of the male population over the age of 50 years suffer the fracture. Diagnostic tests for idiopathic osteoporosis are performed in men under 60 years of age without other potential risk factors of developing the disease. In the majority of cases, their low bone mineral density (BMD) is caused by a low peak bone mass. Secondary osteoporosis occurs in about 30 % of men, and involutionary osteoporosis developed in men over 60 years of age results from their decreased testosterone and IGF-1 levels. The study results showing that BMD levels in both sexes provide similar fracture risk information suggest that the existing diagnostic criteria for female osteoporosis can also be employed in men. It has been proved that biphosphonate and teriparitide therapy significantly increase BMD levels in men. The administration of androgens has been shown to be effective in men with hypogonadism, although their validity for patients with eugonadism has not yet been discussed. An improved knowledge of the bone metabolism and bone remodelling has recently opened the door to an extensive series of molecules that may play a key role in the treatment of male osteoporosis in the future.     

Osteoporosis and hypogonadism in men

It is estimated that almost 1 in 10 men will suffer a fracture caused by osteoporosis after the age of 50 years. Among those are a considerable number of men who will fracture their hip. A number of therapies have demonstrated efficacy in improving bone density in men, and the issue of which therapy and when to institute it is addressed in this article.     

骨质疏松症健康信念量表的信度和效度测定

目的了解骨质疏松症住院患者对骨质疏松预防相关的危险因素、运动及摄钙基本知识的掌握,在此基础上采用因人制宜的健康教育方式,探讨健康教育对患者骨质疏松预防知识掌握的影响。方法对60例老年女性骨质疏松住院患者进行骨质疏松知识问卷调查,根据问卷调查结果有针对性对骨质疏松预防相关的危险因素、运动及摄钙知识进行宣教,比较宣教前后患者对骨质疏松预防知识认知变化情况。结果患者对骨质疏松预防危险因素知识由5.06分提高到8.20分、危险因素知识答对率由44.93%提高到74.53%;运动知识由2.68分提高到4.76分、运动知识答对率由38.30%提高到67.98%;摄钙知识由1.70分提高到4.96分、摄钙知识答对率由20.80%提高到62.00%;骨质疏松整体预防知识由9.42分提高到17.88分、骨质疏松整体预防知识答对率由34.26%提高到67.77%。差异均显著(P < 0.01)。结论老年女性骨质疏松患者对于骨质疏松预防知识认识普遍不足,经因人制宜的宣教干预后,患者对骨质疏松症危险因素认识、运动和摄钙知识水平显著提高,健康宣教对于提高骨质疏松症患者预防知识的掌握切实有效。     

骨质疏松症的现状、流行趋势与研究方向

目的了解上海市部分社区居民的骨质疏松知识认知、骨质疏松预防自我效能和自我管理行为状况及社区宣传干预的效果。方法在上海市20个骨质疏松诊疗管理规范试点社区开展骨质疏松危险因素、防治知识、管理行为等的宣教,宣教前后分别采用方便抽样的方法抽取2 000名居民进行问卷调查,评估宣教干预效果。结果干预后社区居民骨质疏松危险因素知识、运动知识和钙知识的平均正确率较干预前分别提升了20.7%,20.4%和14.5%(P＜0.01)。干预后社区居民的骨质疏松运动效能和摄钙效能,社区居民骨质疏松预防饮食行为、生活方式和运动行为也较干预前显著提升(P＜0.05)。结论经规范化管理和宣教干预后,社区居民对骨质疏松症认知、效能和管理水平显著提高,骨质疏松症规范化管理宣教干预切实有效。     

Osteoporosis

Osteoporosis is the leading cause of disabling and often life-threatening fractures in elderly women. This paper discusses risk factors in osteoporosis such as heredity, race, age, sex, diet, and exercise, as well as disease related causes of bone loss. Early symptoms, clinical findings, and currently used diagnostic techniques are reviewed. And the management of osteoporosis- both treatment of symptomatic disease and its sequelae, and preventive measures designed to maintain skeletal mass and integrity- is described.     

中国骨质疏松症流行病学调查及“健康骨骼”专项行动结果发布

  目的  了解河北省成年居民骨质疏松症患病情况及其影响因素,为制定有针对性的骨质疏松预防措施提供参考依据。  方法  于2017年7 — 9月采用多阶段分层整群抽样方法在河北省石家庄市、承德市和保定市3个市7个区（县）抽取6195名20～80岁常住成年居民进行问卷调查和定量超声骨密度检测。  结果  河北省6195名成年人中,患骨质疏松症者89例,骨质疏松症患病率为1.44 %;多因素非条件logistic回归分析结果显示,女性和年龄 ≥ 50岁是河北省成年居民骨质疏松症患病的危险因素,文化程度中学及以上是河北省成年居民骨质疏松症患病的保护因素。  结论  河北省成年居民骨质疏松症患病率较低,性别、年龄和文化程度是该地区成年居民骨质疏松症患病的主要影响因素。     

Botanicals in Postmenopausal Osteoporosis

Osteoporosis is a systemic bone disease characterized by reduced bone mass and the deterioration of bone microarchitecture leading to bone fragility and an increased risk of fractures. Conventional anti-osteoporotic pharmaceutics are effective in the treatment and prophylaxis of osteoporosis, however they are associated with various side effects that push many women into seeking botanicals as an alternative therapy. Traditional folk medicine is a rich source of bioactive compounds waiting for discovery and investigation that might be used in those patients, and therefore botanicals have recently received increasing attention. The aim of this review of literature is to present the comprehensive information about plant-derived compounds that might be used to maintain bone health in perimenopausal and postmenopausal females.     

Osteoporosis in anorexia nervosa

Anorexia nervosa is a disorder characterized by low body weight and amenorrhoea (in females). These features lead to a risk of osteoporosis, a condition in which bone loss leads to weakening of bone structure and increased fracture risk.     

Socioeconomic status and quality of life in population‐based Australian men: data from the Geelong Osteoporosis Study

Objective : To investigate the relationship between socioeconomic status (SES) and reported perceptions of quality of life (QOL) in a cross‐sectional population‐based analysis of a representative sample of Australian men. Methods : In 917 randomly recruited men aged 24–92 years, we measured QoL in the domains of physical health, psychological health, environment and social relationships, using the Australian World Health Organization Quality of Life Instrument (WHOQOL‐BREF). Residential addresses were cross‐referenced with Australian Bureau of Statistics 2006 census data to ascertain SES. Participants were categorised into lower, mid, or upper SES based on the Index of Relative Socioeconomic Disadvantage and Advantage (IRSAD), the Index of Economic Resources (IER), and the Index of Education and Occupation (IEO). Lifestyle and health information was self‐reported. Results : Males of lower SES reported poorer satisfaction with physical health (OR=0.6, 95%CI 0.4–0.9, p=0.02), psychological health (OR=0.4, 95%CI 0.3–0.7, p<0.001) and environment (OR=0.5, 95%CI 0.3–0.7, p<0.001), although not social relationships (p=0.59). The poorest QOL for each domain was observed in the lower and upper SES groups, representing an inverse U‐shaped pattern of association; however, statistical significance was only observed for psychological health (OR=0.5, 95%CI 0.4–0.7, p<0.001). These relationships were similar for IEO and IER. Conclusions : Men from lower and upper SES groups have lower QOL compared to their counterparts in the mid SES group.