Men and osteoporosis. For years that phrase was considered contradictory. Now, however, osteoporosis is known to afflict a significant number of men as well as women. A new study at the University of Maryland School of Medicine will explore the causes of the disease in men, differences between Caucasian and African-American men, and how the disease can be prevented in the male population.
"Men tend to be the neglected group when osteoporosis is discussed," says Marc Hochberg, M.D., M.P.H. professor of medicine at the University of Maryland School of Medicine and head of Rheumatology and Clinical Immunology at the University of Maryland Medical Center.
While osteoporosis has long been considered a "woman's disease," men accounted for 30 percent of the 1.7 million hip fractures in the United States in 1994. And recent data from the NIH's Third National Health and Nutrition survey suggests that between one and two million men in the United States have osteoporosis and an additional eight to 13 million men have low bone mass. It is anticipated that the occurrence of osteoporosis will worsen as more men live longer.
"We're hoping to find ways to predict the rate of bone density loss in men and how to prevent the disease from occurring. We are also looking for preventative measures that don't involve drug therapy," says Dr. Hochberg.
This single-center study, funded by grants from the Department of Veterans Affairs and the Arthritis Foundation, is the first nationally to look at bone-density differences among Caucasian and African-American males.
"Whites tend to have instances of bone fracture about twice that of African-Americans and we don't know why," Dr. Hochberg says. "We think it's because of differences in bone density and the rate at which bone is replenished."
The study will include 1,000 Caucasian and African-American men age 65 and older who live in the Baltimore metropolitan area. Participants will visit the clinic four times over three years where bone density and body composition will be measured. The impact of other environmental factors, such as diet and exercise, also will be evaluated, as well as reports of falls or other incidents that lead to fractures. The study will enhance understanding of which men are at higher risk of osteoporosis and why.
"The prevalence of osteoporosis is higher in Whites than in Hispanic or African-American men. That's about all we know about bone density among American men," Dr. Hochberg says. "That and the fact that while osteoporosis occurs less frequently in men than women, it's more deadly in the male population." The death rate within one year of a hip fracture is two-fold greater for men than women, he says.
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