Vertebral fractures and bone mineral density in idiopathic, secondary and corticosteroid associated osteoporosis in men
- Dr Davie
- Accepted 28 October 1999
Abstract
OBJECTIVE To investigate bone mineral density (BMD) in men with symptomatic osteoporosis and compare BMD in patients with idiopathic, secondary and corticosteroid associated osteoporosis.
METHODS Age, number of vertebral fractures at presentation and BMD were investigated in men presenting to a bone metabolism clinic with idiopathic (n=105; group 1), secondary (n=67; group 2) and corticosteroid osteoporosis (n=48; group 3). BMD was measured in 176 healthy men (controls). Osteoporosis was diagnosed if there was ≥20% vertebral deformity.
RESULTS Age at peak BMD in controls was 20–29 years at spine (LS-BMD) and femoral neck (FN-BMD). LS-BMD did not change with age but FN-BMD decreased in controls and groups 1 and 2. Mean (SD) age was similar in groups 1 (62.8 (11.5) years, 2 (60.2 (11.0)) years and 3 (62.7 (10.4) years with 45%, 51% and 40% of patients respectively presenting before 60 years. Back pain, present for up to 12 months, was the commonest cause of referral. Vertebral fractures at presentation averaged mean (SD) 2.51 (1.9) in group 1, 2.76 (2.2) in group 2 and 2.48 (1.8) in group 3. LS-BMD Z scores and T scores were more negative in group 1 patients with ≤3 vertebral fractures compared with FN-BMD suggesting a greater trabecular bone deficit. LS-BMD Z score in group 1 is −1.71, lower than in population studies. LS T score associated with fracture was about −2.4 in all groups. T8, T12 and L1 were the most frequent levels for fracture.
CONCLUSIONS Men with symptomatic osteoporosis present in middle age, have low BMD with similar T scores irrespective of aetiology and sustain ≥ 1 fracture.
Footnotes
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Funding: this work was undertaken by the Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust who received a proportion of its funding from the NHS executive.
