Archive for Sunday, December 15, 2002

Osteoporosis puts men at risk, too

December 15, 2002

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The blueprint for building strong bones may be one construction project in which the women have it all over the men.

A recent study found that men and their physicians too often overlook the potential for men, like women, to suffer from a loss of bone density as they age. The risk? Debilitating fractures and even death.

"We know so much less about male osteoporosis than about (the condition) in women," said Dr. Joanne Valeriano-Marcet, an associate professor at the University of South Florida School of Medicine who has examined the effectiveness of treatments and education for dealing with loss of bone density.

Research published recently in the Archives of Internal Medicine found that even men who had suffered fractures were rarely referred for a bone density test. Yet by age 65, men lose bone mass as fast as women. By 75, one-third of men have osteoporosis.

Of the estimated 10 million Americans afflicted with osteoporosis, 2 million are men, said the study's lead author, Gary Kiebzak of the Center for Orthopedic Research and Education at St. Luke's Episcopal Hospital in Houston.

Men's lack of awareness puts some of them at risk for the same debilitating bone breaks suffered by women, who for years have been warned about osteoporosis and advised to take preventive measures, Kiebzak said.

Men fare better than women in maintaining bone density as they age because of differences in lifestyle and physiology, scientists believe. Men typically have larger frames, with more muscle and bone mass. And men do not go through the drastic hormonal changes women experience, particularly menopause's plunge in estrogen, which accelerates bone loss.

But neither gender escapes the body's script for aging. An individual deposits more bone mass than he or she loses through the mid 30s. Then bones begin to gradually lose density. Excessive loss is called osteoporosis.

Osteoporosis typically doesn't announce its presence until a wrist breaks in a minor mishap or back pain leads to discovery of compression fractures in the spine. Many cases are diagnosed after a hip is fractured.

No one knows for certain why some people's bones become dangerously fragile. Thin white women are particularly susceptible. A 50-year-old white female has a 14 percent chance that she will suffer a hip fracture in her lifetime. A white male has a 5-to-6 percent chance. The odds for a black male, however, are 3 percent.

"We really don't know what to tell men. We're still studying the correlation between (bone) density and breaks and at what level a man would be at risk," Valeriano-Marcet said.

The condition can be hereditary, a side effect of other diseases or their treatments, such as radiation for cancer, or the result of unhealthy lifestyles, from inactivity to lack of calcium. "What I see in men is alcohol (abuse) as a major factor," Valeriano-Marcet said.

Osteoporosis is treated with bone-building drugs such as Fosamax and Actonel, approved for men and women by the Food and Drug Administration.

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