Topical Collection "Male Osteoporosis"
Interests: osteoporosis; metabolic bone diseases; parathyroid diseases; multiple endocrine neoplasia; genetic diseases of bone
Special Issues and Collections in MDPI journals
Male osteoporosis still represents a pathological condition that remains largely underdiagnosed and undertreated mainly due to the low frequency of screening and to the controversies in BMD testing standards. Approximately, 30–40% of overall osteoporotic fractures belong to men, and hip fracture in males is strictly associated with increased morbidity and mortality. Gender differences between male and female bone begin during puberty, resulting in wider bones in boys than in girls. In men, testosterone, estrogens, SHBG, and FSH levels interact in determining the bone mass accrual, BMD maintenance, and lifetime decrease. However, genetic factors seem to play a relevant role as well. With respect to women, secondary osteoporosis is more frequent in men accounting for up to 50% of cases; therefore, both complete history and physical examination should be done in all osteoporotic men in order to find clues of possible secondary causes and ultimately to guide laboratory testing.
As a general example of this, in recwent decades, the global rise of obesity and sedentary lifestyles, together with an aging population, lead to increased incidence and prevalence of type 2 diabetes, a known major cause of disability, socioeconomic costs, and increased risk of all-cause mortality. Fragility fractures are increasingly recognized as an important complication of T2DM also in male subjects and are associated with excess morbidity, mortality, and health care costs. Osteoporosis is often an underdiagnosed T2DM related complication.
Although the data from clinical intervention studies are more limited and on a smaller number of male subjects than those emerging from studies carried out in post-menopausal women, bone active agents have been currently approved for the pharmacological therapy of male osteoporosis, consisting of antiresorptive agents, such as aminobisphosphonates or denosumab, and the osteoanabolic agent teriparatide, while testosterone replacement therapy may be considered in patients with hypogonadism.
Since, as also mentioned above, men have fractures about 10 years later in life than women and due to advanced age, they may have more comorbidities, and consequently, their mortality rate is about twice that of women. Therefore, appropriate early diagnosis of male osteoporosis is mandatory in order to start adequate treatment of these subjects, representing a very important step in clinical practice as it may impact on mortality more than in women.
This Topical Collection aims to update the pathophysiology and preclinical approach to male osteoporosis, overall fracture risk in male subjects, including men affected by dysmetabolism, systemic disorders, with or without type 2 diabetes, to move the field forward and suggest how to decrease the fracture rate in the specific clinical scenario.
We welcome both original research and review articles.
Dr. Alberto Falchetti
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- male osteoporosis
- fractures in T2DM
- preclinical and instrumental diagnostic tools of bone fragility in male subjects
- pathogenesis of bone fragility in males, in general and according to a specific clinical scenario
- biomarkers predictive of bone mass reduction as also of bone fragility in males
- prevention of fractures
- the role of antidiabetic drugs on bone health and fracture rate
- the effects of antiosteoporotic drugs on male patients, in general and according to a specific clinical scenario