Secondary Osteoporosis Less Common Than Thought in Men and Women

The prevalence of secondary osteoporosis in men is similar to that in women and is significantly lower than is often reported. The low prevalence in both sexes demonstrates that an extensive and expensive evaluation is not necessary, unless there are clues to underlying conditions.

Romagnoli and coworkers conducted a prospective study of 123 men and 246 women. All patients had a physical examination and biochemical, densitometric, and radiological examinations of the thoracic and lumbar spine. Serum assays were performed. The fracture risk assessment tool (FRAX) was applied.

There were no significant differences between the sexes in the prevalence of primary osteoporosis (52.9% in men vs 50% in women) and secondary osteoporosis (21.1% in men vs 17.5% in women). The prevalence of primary osteoporosis was significantly higher than that of secondary osteoporosis in both sexes. Drug-induced osteoporosis and GI disorders were the most common causes of secondary osteoporosis in both sexes. Evaluation with FRAX showed that in patients with secondary osteoporosis, the 10-year probability for major osteoporotic fractures was significantly lower in men than in women.

The authors noted that a careful medical examination always should be carried out in each patient to exclude potentially reversible causes of bone loss.