Common Questions
What are important risk factors for osteoporosis or hip fracture in men?
Case-control and population studies suggest that risk factors for osteoporosis or hip fracture are similar in men and women (1,2). The risk factors for osteoporosis in men include:
- Age >70 years
- BMI (body mass index)<20 to 35 Kg/m2
- Loss of more than 10 percent of body weight from maximum
- Physical inactivity (participates in no physical activity on a regular basis)
- Use of oral corticosteroids
- Previous fragility factor
- Low BMD (bone mineral density)
- Heavy alcohol use (more than 27 drinks a week)
- Smoking
- Testosterone deficiency
The majority of fractures associated with osteoporosis are due to a fall. Therefore, fall risk factors contribute to fracture risk. The most improtant risk factors are (2):
- Personal history of fall
- Muscle weakness
- Gait deficits
- Visual deficits
- Balance deficits
- Dehydration
- Sedating medication use
Secondary causes of osteoporosis may more often play a role in symptomatic vertebral fractures in men. Fifty percent of men, versus 35 percent of women, will have an identifiable secondary cause (3). Common secondary causes include:
- Hypogonadism
- Glucocorticoid exposure
- Hyperparathyroidism
- Hyperthyroidism
- Multiple Myeloma
- Malabsorption syndromes
- Qaseem A, Snow V, Shekelle P, Hopkins R Jr., Forciea MA, Owens DK for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians.. Screening for Osteoporosis in Men: A Clinical Practice Guideline from the American College of Physicians. Ann Intern Med 2008; 148(9): 680-684.
- National Osteoporosis Foundation. Clinician's guide to prevention and treatment of osteoporosis. 2008. Available online.
- Eastell R, Boyle IT, Compston J, Cooper C, Fogelman I, Francis RM. Management of male osteoporosis: Report of the UK Consensus Group. QJM 1998; 91(2): 71-92.