Male osteoporosis

Varanasi, S.S., Francis, R.M., Berger, C.E., Papiha, S.S., and Datta, H.K. 1999. Mitochondrial DNA deletion associated oxidative stress and severe male osteoporosis. Osteoporos. Int. 10, 143-149. 

Male osteoporosis is often secondary to specific diseases and drugs and responds well to bisphosphonate therapy and lifestyle changes including diet. 

For many reasons, men experience fewer osteoporosis-related fractures than women. Men comprise only approximately 20% of aU persons with osteoporosis. This is likely attributable to men attaining a 20% to 40% higher peak BMD than women and losing BMD at a slower rate after the peak. Men s bones also have a mechanical advantage because the larger bone diameter makes them more fracture-resistant. Finally, men have a shorter life expectancy and experience fewer falls than women. Male osteoporosis remains an underrecognized problem. Although fewer men than women have osteoporosis, men still suffer up to 30% of all hip fractures and are more likely than women to die within 1 year after fracture. ... 

Alkhenizan A, Almarri S, Evans MF Alendronate and male osteoporosis. Can Fam Physician... 

Kamel HK. Male osteoporosis new trends in diagnosis and therapy. Drugs Aging 2005 22 741-748. 

Alendronate, risedronate, and oral ibandronate are FDA approved for prevention and treatment of postmenopausal osteoporosis. IV ibandronate and zoledronic acid are indicated only for treatment of postmenopausal women. Risedronate and alendronate are also approved for male and glucocorticoid-induced osteoporosis. 

Osteoporosis is in many ways a silent disease and osteoporotic fractures occurs mainly in women, the ratio being 1.6 females to 1 male. There are many risk factors that have been identified as increasing the development of osteoporosis and age, sex and life styles factors are some (Box 5.13)... 

In contrast to the Bantu, consumption of high-meat diets by the North American Eskimos has been accompanied by severe osteoporosis. Mazess and Mather ( 0 measured bone densities of both male and female Eskimos of all ages. As early as the fourth decade of life, Eskimo women had bones with less than 857> of the density of age, and sex-matched white women living in the United States. Markedly larger differences of bone occurred in later decades this was true of Eskimos of both sexes. The Eskimo diet, very high in protein, is abundantly supplied with fish, reindeer, moose, caribou, and other meats. 

It appears from these studies that the postprandial responses of postmenopausal women may differ from those of younger men. In studies in which calciuria has been demonstrated, the detrimental effect of such a condition on bone has been implied. Osteoporosis is defined as a diminution of skeletal mass in which the bone is normally mineralized but the amount of bone tissue is lower than normal. Unfortunately, it is seldom diagnosed unless bone fracture occurs 30% of skeletal mass may have been lost by this time (23). Osteoporosis occurs more frequently in females then males and has been estimated as the cause of 90% of all fractures in people over the age of 60 yr (28). Therefore, differences in the postprandial responses of postmenopausal women, a population at high risk for osteoporosis, and men may help to identify contributing factors to the etiology of bone loss. 

Qassification Idiopathic osteoporosis type 1, occurring in postmenopausal females type 11, occurring in senescent males and females (>70 y). Secondary osteoporosis associated with primary disorders such as Cushing s disease, or induced by drugs, e.g chronic therapy with glucocorticoids or heparin. In these forms, the cause can be eliminated. 

Uses Rx prevent osteoporosis male female, Rx steroid-induced osteoporosis, Paget Dz Action -1- N1 abnormal bone resorption Dose Osteoporosis Rx 10 mg/d PO or 70 mg qwk Fosamax plus D 1 tab qwk Steroid-induced osteoporosis Rx 5 mg/d PO Prevention 5 mg/d PO or 35 mg qwk Paget Dz 40 mg/d PO Caution [C, ] Not OK if CrCl <35 mLAnin, w/ NSAID use Contra Esophageal anomalies, inability to sit/stand upright for 30 min, X Ca Disp Tabs, soln SE GI disturbances, esophageal irritation, HA, pain, jaw osteonecrosis (w/ dental procedures, chemo) Interactions -1- Absorption W7 antacids, Ca supls, Fe, food T risk of upper GI bleed W/ ASA NSAIDs EMS May cause cardiac conduction abnormalities d/t T Ca T risk of jaw fractures esp w/ dental procedures OD May cause hypocalcemia and adverse upper-GI effects milk or antacids can be given to bind alendronate... 

Testosterone Main androgen produced by testes. Esterified forms display longer circulatory half lives Treatment of male hypogonadism. Also sometimes used in treatment of post-menopausal breast carcinoma and osteoporosis... 

Unlabeled Uses Hyperlipidemia, lung cancer, male contraception, malnutrition, postmenopausal osteoporosis, rheumatoid arthritis, Sjogren s syndrome, trauma/sur-... 

Verapamil has been shown to block the P-glycoprotein responsible for the transport of many foreign drugs out of cancer (and other) cells (see Chapter 1) other calcium channel blockers appear to have a similar effect. This action is not stereospecific. Verapamil has been shown to partially reverse the resistance of cancer cells to many chemotherapeutic drugs in vitro. Some clinical results suggest similar effects in patients (see Chapter 54). Animal research suggests possible future roles of calcium blockers in the treatment of osteoporosis, fertility disorders and male contraception, immune modulation, and even schistosomiasis. 

It makes Cozaar and Hyzaar for hypertension Vytorin, Zetia, and Zocor to lower cholesterol Pro-pecia for male-pattern baldness Singulair for asthma Fosamax for osteoporosis and Gardasil, a vaccine for cervical cancer but it is also well known for making Vioxx, a pain relief drug taken off the market for causing heart problems. 

With regard to the development of osteopenia or osteoporosis with hypogonadism in males, lack of androgens is considered as a risk factor from the point of view of the quality of the bone. Anabolic steroids act on the bone probably through the androgen receptors on the osteoblasts, but an inhibitory effect on the osteoclasts is also possible. The condition affects mainly the cortical phase of the bone. When anabolic steroids are applied in females, they are usually combined with estrogens. Their application acts preventively against the loss of bone mass, stimulates osteoformation, and reduces the risk of hip fracture. 

Epileptics have low blood Mn A link between mseleni disease and Mn deficiency Low tissue Mn in MSUD and PKU Mn deficiency and hip dislocation in Down s syndrome Low hair Mn in infants with congenital malformations and their mothers Low blood Mn in non-head injury epileptics Low blood Mn in osteoporosis Experimental Mn deficiency in male subjects ... 

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