scholarly journals Management of Osteoporosis in Men: A Narrative Review

2021 ◽  
Vol 22 (24) ◽  
pp. 13640
Author(s):  
Fabio Vescini ◽  
Iacopo Chiodini ◽  
Alberto Falchetti ◽  
Andrea Palermo ◽  
Antonio Stefano Salcuni ◽  
...  
Keyword(s):  
Pathological Condition ◽  
Osteoporotic Fractures ◽  
Clinical History ◽  
Bone Fragility ◽  
Pharmacological Therapy ◽  
Male Osteoporosis ◽  
Testosterone Replacement Therapy ◽  
Mineral Density ◽  
Bmd Testing ◽  
Follicle Stimulating Hormones

Male osteoporosis is a still largely underdiagnosed pathological condition. As a consequence, bone fragility in men remains undertreated mainly due to the low screening frequency and to controversies in the bone mineral density (BMD) testing standards. Up to the 40% of overall osteoporotic fractures affect men, in spite of the fact that women have a significant higher prevalence of osteoporosis. In addition, in males, hip fractures are associated with increased morbidity and mortality as compared to women. Importantly, male fractures occur about 10 years later in life than women, and, therefore, due to the advanced age, men may have more comorbidities and, consequently, their mortality is about twice the rate in women. Gender differences, which begin during puberty, lead to wider bones in males as compared with females. In men, follicle-stimulating hormones, testosterone, estrogens, and sex hormone-binding levels, together with genetic factors, interact in determining the peak of bone mass, BMD maintenance, and lifetime decrease. As compared with women, men are more frequently affected by secondary osteoporosis. Therefore, in all osteoporotic men, a complete clinical history should be collected and a careful physical examination should be done, in order to find clues of a possible underlying diseases and, ultimately, to guide laboratory testing. Currently, the pharmacological therapy of male osteoporosis includes aminobisphosphonates, denosumab, and teriparatide. Hypogonadal patients may be treated with testosterone replacement therapy. Given that the fractures related to mortality are higher in men than in women, treating male subjects with osteoporosis is of the utmost importance in clinical practice, as it may impact on mortality even more than in women.

A CLINICAL STUDY TO EVALUATE THE EFFECT OF ELEG FEM CAPSULES (ASTHISHRINKHALAADI YOGA) IN THE MANAGEMENT OF OSTEOPOROSIS

2021 ◽  
pp. 62-63
Author(s):  
Neha Thakur ◽  
B.L. Mehra ◽  
Sunil Thakur ◽  
Anil Bhardwaj
Keyword(s):  
Quality Of Life ◽  
Clinical Study ◽  
Osteoporotic Fractures ◽  
Bone Fragility ◽  
Drop Out ◽  
Mineral Density ◽  
Life Index ◽  
T Score ◽  
Quality Of Life Index

Osteoporosis is an alarming issue in the society today. It is continuously increasing its signicance with increasing elderly population and is affecting both the sexes at different degrees. It is characterized by low bone mass with microarchitectural deterioration of bone leading to enhanced bone fragility, thus increasing the susceptibility to fracture. Taking into account the references available in various Ayurvedic classics it can be correlated to Asthikshaya. Asthikshaya occurs due to decrease in strength of Asthi Dhatu chiey due to Kala, Swabhava and Vata Prakopa. International Osteoporosis Foundation estimated that the annual direct cost of treating osteoporotic fractures has increased grossly. In India the general population is not much aware about the hazardous complications of osteoporosis. The modern pharmacological treatment is long and beyond the nancial reach of common people. Therefore the best way to deal with it is to prevent this as early as possible. To achieve this aim a clinical study was conducted to evaluate the effect of an Ayurvedic Formulation known as Eleg Fem capsules (Asthishrinkhalaadi Yoga) in osteoporotic patients. In the clinical trial 30 patients above the age of 40 years with low BMD T-Score were registered from OPD and IPD of Kayachikitsa department of Rajiv Gandhi Govt. Post Graduate Ayurvedic College and Hospital Paprola, Kangra. Out of 30 patients, 27 completed the trial and 3 patients were drop out. Criteria of assessment of patients was change in bone mineral density (BMD T- Score) and change in the score of Quality of Life Index Questionnaire for Osteoporosis (QUALEFFO-41). All the registered patients were given the formulation for 6 weeks. Improvement was observed with statistically signicant results on mean BMD TScore and moderately signicant result on Quality of Life Index scoring. The study revealed that the Eleg Fem capsules (Asthishrinkhalaadi Yoga) is a safe and effective therapy in the Osteoporotic patients.

scholarly journals Bone density testing in clinical practice

2006 ◽  
Vol 50 (4) ◽  
pp. 586-595 ◽  
Author(s):  
E. Michael Lewiecki ◽  
João Lindolfo C. Borges
Keyword(s):  
Forearm Fracture ◽  
Fragility Fractures ◽  
Cost Effective ◽  
Reference Population ◽  
Pharmacological Therapy ◽  
World Health ◽  
Mineral Density ◽  
Skeletal Health ◽  
T Score ◽  
Bmd Testing

The diagnosis of osteoporosis and monitoring of treatment is a challenge for physicians due to the large number of available tests and complexities of interpretation. Bone mineral density (BMD) testing is a non-invasive measurement to assess skeletal health. The "gold-standard" technology for diagnosis and monitoring is dual-energy X-ray absorptiometry (DXA) of the spine, hip, or forearm. Fracture risk can be predicted using DXA and other technologies at many skeletal sites. Despite guidelines for selecting patients for BMD testing and identifying those most likely to benefit from treatment, many patients are not being tested or receiving therapy. Even patients with very high risk of fracture, such as those on long-term glucocorticoid therapy or with prevalent fragility fractures, are often not managed appropriately. The optimal testing strategy varies according to local availability and affordability of BMD testing. The role of BMD testing to monitor therapy is still being defined, and interpretation of serial studies requires special attention to instrument calibration, acquisition technique, analysis, and precision assessment. BMD is usually reported as a T-score, the standard deviation variance of the patient's BMD compared to a normal young-adult reference population. BMD in postmenopausal women is classified as normal, osteopenia, or osteoporosis according to criteria established by the World Health Organization. Standardized methodologies are being developed to establish cost-effective intervention thresholds for pharmacological therapy based on T-score combined with clinical risk factors for fracture.

scholarly journals Redefining osteoporosis treatment: who to treat and how long to treat

2006 ◽  
Vol 50 (4) ◽  
pp. 694-704 ◽  
Author(s):  
E. Michael Lewiecki ◽  
Stuart L. Silverman
Keyword(s):  
Risk Factors ◽  
Fracture Risk ◽  
Weight Bearing ◽  
Pharmacological Therapy ◽  
Clinical Risk Factors ◽  
Common Disease ◽  
Mineral Density ◽  
Clinical Risk ◽  
Increased Risk ◽  
Bmd Testing

Osteoporosis is a common disease that is associated with increased risk of fractures and serious clinical consequences. Bone mineral density (BMD) testing is used to diagnose osteoporosis, estimate the risk of fracture, and monitor changes in BMD over time. Combining clinical risk factors for fracture with BMD is a better predictor of fracture risk than BMD or clinical risk factors alone. Methodologies are being developed to use BMD and validated risk factors to estimate the 10-year probability of fracture, and then combine fracture probability with country-specific economic assumptions to determine cost-effective intervention thresholds. The decision to treat is based on factors that also include availability of therapy, patient preferences, and co-morbidities. All patients benefit from nonpharmacological lifestyle treatments such a weight-bearing exercise, adequate intake of calcium and vitamin D, fall prevention, avoidance of cigarette smoking and bone-toxic drugs, and moderation of alcohol intake. Patients at high risk for fracture should be considered for pharmacological therapy, which can reduce fracture risk by about 50%.

scholarly journals EFFECT OF BETA-BLOCKERS ON BONE MINERAL DENSITY AND OSTEOPOROTIC FRACTURES

2013 ◽  
Vol 16 (1) ◽  
pp. 35-38
Author(s):  
K E Sobchenko ◽  
I A Skripnikova ◽  
E S Abirova ◽  
P A Ptichkina
Keyword(s):  
Bone Mineral Density ◽  
Cardiovascular Disease ◽  
Bone Mass ◽  
Beta Blockers ◽  
Osteoporotic Fractures ◽  
Bone Fragility ◽  
Mechanisms Of Action ◽  
Current Data ◽  
Mineral Density ◽  
Fracture Development

This review presents the current data on the pleiotropic effects of beta-blockers in particular on the effect on bone mass and fracture development by means of increased bone fragility. In this article we discuss the mechanisms of action of beta-blockers on bone metabolism and their possible protective effect on bone tissue in the treatment of cardiovascular disease.

scholarly journals Osteoporosis: Current Concepts

Joints ◽  
2018 ◽  
Vol 06 (02) ◽  
pp. 122-127 ◽  
Author(s):  
Ibrahim Akkawi ◽  
Hassan Zmerly
Keyword(s):  
Fracture Risk ◽  
Osteoporosis Treatment ◽  
Bone Fragility ◽  
Pharmacological Therapy ◽  
Bone Architecture ◽  
World Health ◽  
Mineral Density ◽  
Diagnosis Of Osteoporosis ◽  
Average Value ◽  
Health Organization

AbstractOsteoporosis is a worldwide disease characterized by reduction of bone mass and alteration of bone architecture resulting in increased bone fragility and increased fracture risk. Causes of osteoporosis include increasing age, female sex, postmenopausal status, hypogonadism or premature ovarian failure, low body mass index, ethnic background, rheumatoid arthritis, low bone mineral density (BMD), vitamin D deficiency, low calcium intake, hyperkyphosis, current smoking, alcohol abuse, immobilization, and long-term use of certain medications. The diagnosis of osteoporosis is established by measurement of BMD of the hip and spine using dual energy X-ray absorptiometry. According to the World Health Organization criteria, osteoporosis is defined as a BMD that lies 2.5 standard deviation or more below the average value for young healthy women. Bone turnover biomarker detection may be useful in monitoring osteoporosis treatment and assessing fracture risk but not for diagnosis of osteoporosis. Management of osteoporosis consists of nonpharmacological interventions, which are recommended for all subjects, and pharmacological therapy in all postmenopausal women who have had an osteoporotic fracture or have BMD values consistent with osteoporosis.

Determinants and assessment of bone strength

2001 ◽  
Vol 7 (2) ◽  
pp. 81-85
Author(s):  
Richard Keen
Keyword(s):  
Bone Strength ◽  
Osteoporotic Fractures ◽  
Bone Fragility ◽  
Mineral Density ◽  
Additional Information ◽  
Skeletal Disease ◽  
Strength Based ◽  
Drug Treatments ◽  
Fracture Bone ◽  
Future Fracture

Osteoporosis is a systemic skeletal disease characterised by low bone mass and micro-architectual deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Bone mineral density is a major component of bone strength and is predictive of future fracture risk. It is possible to measure BMD non-invasively at various skeletal sites using dual energy absorptiometry. Techniques such as quantitative ultrasound and magnetic resonance imaging also provide additional information on other facets of skeletal strength, although at present further research is required before they are incorporated into routine clinical practice. There is currently much interest in identifying factors involved in the determination of BMD and bone strength. Based on this knowledge, it may be possible to identify subjects who will have low BMD and will therefore be at risk of future fracture. Lifestyle interventions and drug treatments could therefore be targeted to "high risk" subjects to reduce the burden of osteoporotic fractures.

scholarly journals Osteoporosis: Therapeutic Options

Folia Medica ◽  
2016 ◽  
Vol 57 (3-4) ◽  
pp. 181-190 ◽  
Author(s):  
Stefka Ivanova ◽  
Liliya Vasileva ◽  
Stanislava Ivanova ◽  
Lily Peikova ◽  
Danka Obreshkova
Keyword(s):  
Pharmacological Treatment ◽  
Healthy Lifestyle ◽  
Treatment Options ◽  
Bone Fragility ◽  
Pharmacological Therapy ◽  
World Health ◽  
Bone Homeostasis ◽  
Mineral Density ◽  
Pharmacological Agents ◽  
Prevention Of Osteoporosis

Abstract The definition of osteoporosis was originally formulated at a conference of the World Health Organization (WHO) in 1993 as ‘a systemic skeletal disease characterized by decreased bone mass and altered micro-architecture of bone tissue, leading to enhanced bone fragility and risk of fractures’. Osteoporosis is characterized by low bone mineral density (BMD) and loss of the structural and bio-mechanical properties that are required to maintain bone homeostasis. This review aims to address the currently available options in prevention and treatment of osteoporosis. Management of osteoporosis includes non-pharmacological treatment - diet rich of calcium and vitamin D, healthy lifestyle, proper exercise plan, and pharmacological therapy. Combination of non-pharmacological and pharmacological treatment options have to be considered for prevention of osteoporosis and minimization of the risk of fractures. Given the heterogeneity of osteoporosis syndrome and lack of significant number of comparative studies, the choice of a pharmacological agents should be individualized.

scholarly journals Disorders of bone mineral density associated with pregnancy and lactation (a literature review)

2016 ◽  
pp. 32-35
Author(s):  
L. N. Dolgova ◽  
I. G. Krasivina
Keyword(s):  
Bone Mineral Density ◽  
Literature Review ◽  
Economic Burden ◽  
Osteoporotic Fractures ◽  
International Classification Of Diseases ◽  
Bone Fragility ◽  
Mineral Density ◽  
Classification Of Diseases ◽  
Pregnancy And Lactation

Traditionally, the problem of osteoporosis (OP) and osteopenia (OPe) in women is associated with the period of menopause. Increased bone fragility and osteoporotic fractures in pregnant, postpartum and breast-feeding women is less expected but the socio-economic burden can be significant. Neither the existing classification of OP nor the International Classification of Diseases separate OP associated with pregnancy, childbirth and lactation [1].

scholarly journals Anxiety Levels Predict Bone Mineral Density in Postmenopausal Women Undergoing Oral Bisphosphonates: A Two-Year Follow-Up

2021 ◽  
Vol 18 (15) ◽  
pp. 8144
Author(s):  
Gabriella Martino ◽  
Federica Bellone ◽  
Carmelo M. Vicario ◽  
Agostino Gaudio ◽  
Andrea Caputo ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Rating Scale ◽  
Osteoporotic Fractures ◽  
Oral Bisphosphonates ◽  
Mineral Density ◽  
X Ray ◽  
Hamilton Anxiety Rating Scale ◽  
Anxiety Levels

Clinical psychological factors may predict medical diseases. Anxiety level has been associated with osteoporosis, but its role on bone mineral density (BMD) change is still unknown. This study aimed to investigate the association between anxiety levels and both adherence and treatment response to oral bisphosphonates (BPs) in postmenopausal osteoporosis. BMD and anxiety levels were evaluated trough dual-energy X-ray absorptiometry and the Hamilton Anxiety Rating Scale (HAM-A), respectively. Participants received weekly medication with alendronate or risedronate and were grouped according to the HAM-A scores into tertiles (HAM-A 3 > HAM-A 2 > HAM-A 1). After 24 months, BMD changes were different among the HAM-A tertiles. The median lumbar BMD change was significantly greater in both the HAM-A 2 and HAM-A 3 in comparison with the HAM-A 1. The same trend was observed for femoral BMD change. Adherence to BPs was >75% in 68% of patients in the HAM-A 1, 79% of patients in the HAM-A 2, and 89% of patients in the HAM-A 3 (p = 0.0014). After correcting for age, body mass index, depressive symptoms, and the 10-yr. probability of osteoporotic fractures, anxiety levels independently predicted lumbar BMD change (β = 0.3417, SE 0.145, p = 0.02). In conclusion, women with higher anxiety levels reported greater BMD improvement, highlighting that anxiety was associated with adherence and response to osteoporosis medical treatment, although further research on this topic is needed.

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