I would like to comment on the work of Stafford et al1 on national trends in osteoporosis. Many consider osteoporosis to be exclusively a woman’s disease. However, 2 million men in the United States have osteoporosis (compared with 8 million women). Millions more men and women have low bone density, placing them at risk for the disease.2
My concern is therefore that 91% to 96% of the patients mentioned by Stafford et al1 were women and 70% to 80% were older than 65 years. The prevalence of osteoporosis based on bone density at the femoral neck was found to the between 18% and 28% in women and 22% in men older than 50 years. Fractures are the most serious consequence of osteoporosis. In general, it is agreed that the lifetime risk of osteoporotic fracture in men is around one third of that in women (the lifetime risk of a hip fracture in white men is 13% to 25%; the prevalence of vertebral fracture is as high in men as in women). A second concern relates to the future of osteoporosis prevention and treatment if the public, decision makers, and patients are unaware that men can be affected by osteoporosis.
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