Current issues of diagnosis and treatment of osteoporosis in men in general practice

Cover Page


The author revises the latest evidence in the literature regarding managing of osteoporosis in men. Osteoporosis is an important under-recognized problem threatening men. Among people over 50 years of age, a fifth of men will suffer a fragility fracture during their remaining lifetime. The leading risk factors of male osteoporosis are genetic predisposition, low sex hormones and secondary osteoporosis. The latter comprises up to 40% of all male osteoporosis cases. The most common causes of secondary osteoporosis in men are alcohol abuse, endogenic and exogenic hypercortisolism and hypogonadism. Treatment of the underlying disease may result in BMD increase and probably fracture risk improvement. Bisphosphonates (alendronate, risedronate and zoledronic acid), denosumab and teriparatide are approved for treatment of male osteoporosis. Non-pharmacological treatment including avoiding smoking and excessive drinking, health lifestyle and a diet rich in bone-healthy nutrients should also be considered.

Olga M Lesnyak

Author for correspondence.
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

DSc, professor of the Department of Family Medicine

  • Johnell O, Kanis JA. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005;16(Suppl 2):S3-S7. doi: 10.1007/s00198-004-1702-6.
  • Лесняк О.М. Аудит состояния проблемы остеопороза в странах Восточной Европы и Центральной Азии. 2010 // Остеопороз и остеопатии. – 2011. – № 2. – С. 3–6. [Lesnyak OM. Audit sostoyaniya problemy osteoporoza v stranakh Vostochnoi Evropy i Tsentral’noi Azii. 2010. Osteoporoz i osteopatii. 2011;(2):3-6 (In Russ.)]
  • Schousboe JT, Fink HA, Taylor BC, et al. Association between self-reported prior wrist fractures and risk of subsequent hip and radiographic vertebral fractures in older women: a prospective study. J Bone Miner Res. 2005;20(1):100-6. doi: 10.1359/JBMR.041025.
  • Barrett-Connor E, Sajjan SG, Siris ES, et al. Wrist fracture as a predictor of future fractures in younger versus older postmenopausal women: results from the National Osteoporosis Risk Assessment (NORA). Osteoporos Int. 2008;19(5):607-13. doi: 10.1007/s00198-007-0508-8.
  • Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17:1726-1733. doi: 10.1007/s00198-006-0172-4.
  • Kanis J, Johnell O, Gullberg B, et al. Risk factors for hip fracture in men from Southern Europe: the MEDOS Study. Osteoporos Int. 1999;9:45-54. doi: 10.1007/s001980050115.
  • Cooley H, Jones G. A population-based study of fracture incidence in southern Tasmania: lifetime fracture risk and evidence for geographic variations within the same country. Osteoporos Int. 2001;12:124-130. doi: 10.1007/s001980170144.
  • Merrill RM, Weed DL, Feuer EJ. The lifetime risk of developing prostate cancer in white and black men. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 1997;6:763-768.
  • Михайлов Е.Е., Беневоленская Л.И. Руководство по остеопорозу / Под ред. Л.И. Беневоленской. – М.: БИНОМ. Лаборатория знаний, 2003. – С. 10–55. [Mikhailov EE, Benevolenskaya LI. Rukovodstvo po osteoporozu. Ed by L.I. Benevolenskaya. Mosсow: BINOM, Laboratoriya znanii; 2003. P. 10–55. (In Russ.)]
  • Гладкова Е.Н., Ходырев В.Н., Лесняк О.М. Эпидемиологическое исследование остеопоротических переломов у жителей Среднего Урала старших возрастных групп // Научно-практическая ревматология. – 2014. – T. 52. – № 6. – С. 643–649. [Gladkova EN, Khodyrev VN, Lesnyak OM. An epidemiological survey of osteoporotic fractures in older residents from the Middle Urals. Rheumatology Science and Practice. 2014;52(6):643-649. (In Russ.)]
  • Schwartz AV, Kelsey JL, Maggi S, et al. International variation in the incidence of hip fractures: cross-national project on osteoporosis for the World Health Organization Program for Research on Aging. Osteoporos Int. 1999;9:242-253. doi: 10.1007/s001980050144.
  • Czerwinski E, Kanis JA, Trybulec B, et al. The incidence and risk of hip fracture in Poland. Osteoporos Int. 2009;20(8):1363-1367. doi: 10.1007/s00198-008-0787-8.
  • Kanis JA, Bianchi G, Bilezikian JP, et. al. Towards a diagnostic and therapeutic consensus in male osteoporosis. Osteoporos Int. 2011;22:2789-2798. doi: 10.1007/s00198-011-1632-z.
  • Остеопороз / под ред. О.М. Лесняк, Л.И. Беневоленской. – 2-е изд., перераб. и доп. – М.: ГЭОТАР-Медиа, 2011. – 272 с. – Cерия «Клинические рекомендации». [steoporoz. Ed by O.M. Lesnyak, L.I. Benevolenskoi. Moscow: GEOTAR-Media; 2011. 272 p. Seriya “Klinicheskie rekomendatsii”. (In Russ.)]
  • Khosla S, Amin S, Orwoll E. Osteoporosis in men. Endocr Rev. 2008;29:441-464. doi: 10.1210/er.2008-0002.
  • Riggs BL, Melton LJ. Medical progress series: involutional osteoporosis. N Engl J Med. 314:1676-1686;
  • Ebeling PR. Clinical practice. Osteoporosis in men. New Engl J Med. 2008;358:1474-1482. doi: 10.1056/NEJMcp0707217.
  • Клинические рекомендации по профилактике и ведению больных с остеопорозом / под ред. проф. О.М. Лесняк; Российская ассоциация по остеопорозу. – Ярославль: ИПК «Литера», 2012. – 24 с. [Klinicheskie rekomendatsii po profilaktike i vedeniyu bol’nykh s osteoporozom / Ed by prof. O.M. Lesnyak. Rossiiskaya assotsiatsiya po osteoporozu. Yaroslavl’: Litera; 2012. 24 p. (In Russ.)]
  • Лесняк О.М. Остеопороз у мужчин — проблема, недооцененная клинической медициной // Эффективная фармакотерапия. – 2016. – № 17. – С. 28–32. [Lesnyak OM. Osteoporosis in Men – a Problem Underestimated by Clinical Medicine. Effektivnaya farmakoterapiya. 2016;(17):28-32. (In Russ.)]
  • Остеопороз. Диагностика и лечение / под ред. Дэйла В. Стоувэлла : пер.с англ. ; под ред. О.М. Лесняк. – М.: ГЭОТАР-Медиа, 2015. – 288 с. [Osteoporoz. Diagnostika i lechenie. Ed by D.V. Stouvella. Ed by O.M. Lesnyak. Moscow: GEOTAR-Media; 2015. 288 p. (In Russ.)]
  • Zhou J, Wang T, Zhao X, et al. Comparative Efficacy of Bisphosphonates to Prevent Fracture in Men with Osteoporosis: A Systematic Review with Network Meta-Analyses. Rheumatol Ther. 2016;3:117-128. doi: 10.1007/s40744-016-0030-6.
  • Lyles KW, Colon-Emeric CS, Magaziner JS, et al. Zoledronic acid and clinical fractures and mortality afterhip fracture. N Engl J Med. 2007;357:1799-1809. doi: 10.1056/NEJMoa074941.
  • Orwoll E, Teglbjaerg CS, Langdahl BL, et al. A Randomised Placebo-Controlled Study of the Effects of Denosumab for the Treatment of Men with Low Bone Mineral Density. J Clin Endocrin Metab. 2012;97(9):3161-69. doi: 10.1210/jc.2012-1569.
  • Langdahl BL, Teglbjaerg CS, Ho PR, et al. A 24-month study evaluating the efficacy and safety of denosumab for the treatment of men with low bone mineral density: results from the ADAMO study. J Clin Endocrinol Metab. 2015;100(4):1335-1342. doi: 10.1210/jc.2014-4079.
  • Профилактика, диагностика и лечение дефицита витамина D и кальция среди взрослого населения и у пациентов с остеопорозом. Рекомендации Российской ассоциации по остеопорозу / под ред. О.М. Лесняк. – М.: ГЭОТАР-Медиа, 2016. – 94 с. [Profilaktika, diagnostika i lechenie defitsita vitamina D i kal’tsiya sredi vzroslogo naseleniya i u patsientov s osteoporozom. Rekomendatsii Rossiiskoi assotsiatsii po osteoporozu. Ed by O.M. Lesnyak. Moscow: GEOTAR-Media; 2016. 94 p. (In Russ.)]

Supplementary files

There are no supplementary files to display.


Abstract - 261

PDF (Russian) - 346

Copyright (c) 2017 Lesnyak O.M.

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.