Osteoporosis in men: an Endocrine Society clinical practice guideline.
OBJECTIVE
The aim was to formulate practice guidelines for management of osteoporosis in men.


METHODS
We used the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and evidence quality.


METHODS
Consensus was guided by systematic evidence reviews, one in-person meeting, and multiple conference calls and e-mails. Task Force drafts were reviewed successively by The Endocrine Society's Clinical Guidelines Subcommittee and Clinical Affairs Core Committee; representatives of ASBMR, ECTS, ESE, ISCD; and members at large. At each stage, the Task Force received written comments and incorporated needed changes. The reviewed document was approved by The Endocrine Society Council before submission for peer review.


CONCLUSIONS
Osteoporosis in men causes significant morbidity and mortality. We recommend testing higher risk men [aged ≥70 and men aged 50-69 who have risk factors (e.g. low body weight, prior fracture as an adult, smoking, etc.)] using central dual-energy x-ray absorptiometry. Laboratory testing should be done to detect contributing causes. Adequate calcium and vitamin D and weight-bearing exercise should be encouraged; smoking and excessive alcohol should be avoided. Pharmacological treatment is recommended for men aged 50 or older who have had spine or hip fractures, those with T-scores of -2.5 or below, and men at high risk of fracture based on low bone mineral density and/or clinical risk factors. Treatment should be monitored with serial dual-energy x-ray absorptiometry testing.
Mercy Health Osteoporosis & Bone Health Services, Cincinnati Ohio 45236, USA.
Nelson B
NB
Watts
Robert A
RA
Adler
John P
JP
Bilezikian
Matthew T
MT
Drake
Richard
R
Eastell
Eric S
ES
Orwoll
Joel S
JS
Finkelstein
D000368:Aged; D032921:Consensus; D004704:Endocrinology / Q000592:standards*; D019317:Evidence-Based Medicine / Q000592:standards*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D012307:Risk Factors