Osteoporosis ‘markedly undiagnosed’ in elderly men
MedWire News: Osteoporosis and vertebral fractures are common in elderly men, report Danish researchers who also found that osteoporosis in these men is markedly underdiagnosed.
Morten Frost (Odense University Hospital, Kloevervaenget) and team evaluated the prevalence of osteoporosis and vertebral deformities in 600 Danish men, aged 60-74 years, using dual X-ray absorptiometry (DXA) and vertebral fracture assessment (VFA), respectively.
They also investigated the impact of applying Danish reference values for estimating the prevalence of osteoporosis, as opposed to National Health and Nutrition Examination Survey (NHANES)-III hip and Hologic lumbar spine values.
They defined osteoporosis as a T-score at the total hip, femoral neck, or the lumbar spine of -2.5 or less.
At inclusion, osteoporosis was diagnosed in less than 1% of the participants.
Combined NHANES-III hip and Hologic lumbar spine reference values provided clinically similar estimates of osteoporosis to the Danish reference values, at 11.5% and 10.2% of the study population, respectively.
However, there were significant differences with regard to the prevalence of osteoporosis in specific regions. For example, osteoporosis was more common in the total hip and femoral neck when Danish reference values were used (4.4 vs 0.5%, and 5.8 vs 4.1%, respectively), whereas the Danish reference values resulted in a lower prevalence of osteoporosis in the lumbar spine (4.6 vs 8.0%).
Frost and team suggest that the differences observed when only one region was evaluated may be explained by differences in genetics and the distribution of lifestyle factors.
VFA revealed that 6.3% of the study population had at least one vertebral fracture. These individuals had a significantly lower bone mineral density at all sites, but only 24% of these cases had osteoporosis.
"The International Society of Clinical Densitometry currently recommends the use of VFA in men with a low T-score and one of several risk factors," explain Frost et al in the journal Age and Aging. However, "our data demonstrate that VFA adds important information on bone status not captured by T-scores derived from DXA."
They therefore suggest that VFA should be used in all men evaluated with DXA.
MedWire (http://www.medwire-news.md/) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012
By Nikki Withers