Osteoporosis in men

Published on January 19, 2015   41 min
Hello, my name is Peter Ebeling, and I'm the head of the Department of Medicine in the School for Clinical Sciences at the Monash Health Translation Precinct in Victoria, Australia. My Henry Stewart talk today is about osteoporosis in men.
My potential conflicts are listed here. I receive departmental research funding from Merck, Novartis, Amgen, and Eli-Lilly, and I've received honoraria from Amgen and Merck.
Today, I'd like to discuss with you epidemiology and mechanisms of bone loss in men and the importance of estradiol. I'd like to review the Endocrine Society guidelines on osteoporosis in men. I'd like to assess risk factors for osteoporosis in men, and review osteoporosis treatments and gaps in our evidence base.
We've spent 20 years studying osteoporosis in men. And these are data from Cyrus Cooper when we were working together at the Mayo Clinic. These data show that with aging, vertebral and hip fractures increasing in men, but colles fractures do not. The number of hip fractures and vertebral fractures occurring in men are about half that occurring with aging in women. So it is an important health problem.
In fact, one third of hip fractures occur in men. The increase in men with hip fractures is due to both an increase in longevity and a later-born or secular increase. However, now we're seeing that age-related hip fracture incidence rates in many Western countries are increasing in women, but not so much in men. And the mortality rates after a hip fracture in men are about 50% higher than those in women at a rate of 37.5% in 12 months.
This slide shows the annual and projected rates in hip fractures in the United States from 2010 to 2020. I think what's striking here is that hip fractures in men will increase by 52% over that time, whereas there'll actually be a decrease of 3.5% in women. What this means is that hip fractures will increase by 12% overall to 289,000 in 2030. And much of this increase will be attributable to increases in hip fractures in men. So over the next 20 years, the rising numbers of hip fractures in men will counter balance decreasing numbers of hip fractures in women.