Background A relatively small amount of research has been carried out on male osteoporosis (OP). Thus, the appropriate age at which to test for OP via DXA scan in men is not known. Further, the t-score threshold at which to diagnose OP in men is not known - the female level of a t-score lower than -2.5 in either the hip or lumbar spine is generally defined as OP in men.
Objectives To identify the most appropriate age at which to start testing for OP via DXA scan in males, assuming that male OP is defined as a t-score lower than -2.5.
Methods Data of men that attended for a DXA scan at a UK district general hospital between June 2004 and October 2010 were included in the analysis. The following data was collated: age, t-scores of lumbar spine and proximal femur, and previous fragility fracture status. Analysis was carried out for each of the following lowest t-score levels in the hip or lumbar spine: -1.5, -2, -2.5, -3. For each t-score level, receiver operating characteristic (ROC) curve analysis was used to identify the lower age threshold at which to start testing for low BMD in men. The lower age threshold was identified as the age that gave 85% sensitivity that older individuals had a lower t-score. The area under the curve (AUC) was calculated for each ROC curve.
Results 8,196 males were included in the analysis. The mean age of the group was 63.41 years (SD 12.70). Mean BMI was 27.37 Kg/m2 (SD 3.82). The mean lowest t-score was -1.61 (SD 1.30). 999 (12.19%) of the group had previously sustained a fragility fracture. The lower age threshold for each t-score level, the associated specificity and the AUC of each ROC curve are displayed in table 1.
Conclusions This study indicates that an appropriate lower age threshold at which to start testing for OP with DXA scan in males is 63 years. The study also indicates that the t-score level at which male OP is defined may significantly affect the appropriate age threshold at which to test via DXA scan. These findings can guide cost-effective DXA scanning in the male population. Further research is required to evaluate the most appropriate age range at which to test for low BMD via DXA in the male population.
Disclosure of Interest None Declared
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