Background/Purpose: Osteoporosis (OP) in Males is prevalent and frequently under-recognized. There are a number of known demographic factors such as age, race and BMI as well as secondary causes of low bone mineral density (BMD) i.e. osteopenia and OP. The effect of these on the prevalence of low BMD has not been well quantified. This study aims to describe the prevalence of the demographic factors and SC in men with low BMD and also assess their impact on the prevalence.
Methods: Retrospective chart review of men who underwent DEXA scan performed at UMC from 2005- 2009 was done. Data regarding BMD, demographics i.e. age, race, height, weight, BMI, secondary medical causes, medications, social factors such as smoking and alcohol use was abstracted, tabulated and analyzed using STATA software. Statistical significance was assessed using T-test and Odds ratio as appropriate.

Results: A total of 237 charts were analyzed. There were 158 whites (W), 79 African-Americans (AA) 66 patients had normal BMD. Low bone density was prevalent and seen in 171 patients (75.9%). Amongst these 61 had T-score < -2.5 (osteoporosis) and 110 had T-score > – 2.5 and <-1.0 (osteopenia) BMD.  There were no racial differences in prevalence of low BMD and was seen in 77.21 % of AA and 69.62 % of W males tested. The prevalence results are presented in the table with significant differences highlighted.

In this cohort of patients undergoing DEXA scan, a number of underlying factors are present with low BMD. Amongst these, low BMI, overall medication use, smoking and respiratory disorders were found to be significantly more prevalent than others. No difference was found with older age or race but there was significantly higher prevalence of low BMI with low BMD.  Secondary medical disorders were prevalent in the cohort (>70%).  But, there was no difference in their prevalence except for asthma/COPD among those with low versus normal BMD. Similarly, medication use was common and was significantly more prevalent with low BMD. Steroid use (>5 mg) was more frequent with low BMD but not statistically significantly. Smoking was significantly more prevalent with low BMD and alcohol use could not be quantified due to small numbers. The results suggest that low BMI, smoking and overall medication use may be better associated with low BMD and potentially better predictors than race, older age and secondary medical disorders. Limitations of this study include its retrospective design and small sample size. Nonetheless these results highlight that the effect of these underlying factors needs to be better quantified in population studies, so that males at risk of OP may be better identified and screened earlier.

Conclusion: Low BMI, asthma/COPD, smoking and overall medication use were found to be more prevalent in the male patients with low BMD as compared to those with normal BMD in patients undergoing bone mass measurement. This may have significant implications on decision to consider screening for OP in males.