Sex and Gender Considerations in Male Patients With Osteoporosis
Sex and Gender Considerations in Male Patients With Osteoporosis
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DOI：
10.1007/s11999-011-1849-3
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发表时间：
2011-07-01
影响因子：
4.2
通讯作者：
Lane, Joseph M.
中科院分区：
文献类型：
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作者：
Dy, Christopher J.;LaMont, Lauren E.;Lane, Joseph M.
在男性和女性中，骨质疏松症仍然没有得到充分的认识和治疗，但男性脆性骨折的发病率和死亡率更高。虽然男性在髋部骨折时表现出晚期合并症，但与骨质疏松症的病理生理学和治疗相关的不同性别和性别特异性因素进一步影响发病率和死亡率。我们评估了导致男性骨质疏松症发病率和死亡率增加的性别差异。骨生物学和形态学的特定差异可能影响骨质疏松症的病理生理学、药物治疗的选择和外科植入物的选择。此外，雌激素代谢可能在骨折预防和愈合中发挥关键作用。男性和女性之间的筛查和预防建议的性别差异可能会影响骨质疏松症的严重程度。男子的一级、二级和三级预防工作落后于妇女。这可能是由于对男性骨质疏松症的筛查指南缺乏共识，但也可能是由于医生和患者对骨质疏松症及其潜在的衰弱后果缺乏认识。这些差异呼吁医疗保健提供者采取行动，提高对这种潜在衰弱疾病的早期预防和治疗的认识。需要继续对诊断为骨质疏松症的男女之间的差异进行前瞻性研究，并对所有关于骨质疏松症的研究中的数据进行性别分层。
Osteoporosis remains underrecognized and undertreated in both men and women, but men who sustain fragility fractures experience greater morbidity and mortality. While men exhibit advanced comorbidity at the time of hip fracture presentation, there are distinct sex- and gender-specific factors related to the pathophysiology and treatment of osteoporosis that further influence morbidity and mortality.With a selective review of the literature, we evaluated sex- and gender-based differences contributing to increased morbidity and mortality in men with osteoporosis.Sex-specific differences in bone biology and morphology may affect the pathophysiology of osteoporosis, choice of pharmacotherapy, and surgical implant selection. Additionally, estrogen metabolism may play a key role in both fracture prevention and healing. Gender-based differences in recommendations for screening and prevention between men and women may influence the severity at which osteoporosis is recognized. Primary, secondary, and tertiary prevention efforts in men lag behind those of women. This may be due to a lack of consensus regarding screening guidelines for osteoporosis in men but may be attributed to lack of awareness in the physician and patient about osteoporosis and its potentially debilitating consequences.These disparities are a call to action for healthcare providers to raise awareness for early prevention and treatment of this potentially debilitating disease, particularly in men.Continued prospective research on the differences between men and women diagnosed with osteoporosis is needed, as well as sex-specific stratification of data in all studies on osteoporosis.