Background: Osteoporosis in men is markedly underdiagnosed and undertreated even though the morbidity and mortality with fragility fractures are higher in men. The study aimed to identify predictors of osteoporosis and prevalent fractures among adult Filipino men.
Methodology: An analytical cross-sectional study of 184 Filipino men ³50 years screened for bone mineral density was performed. Age, weight, body mass index (BMI), Osteoporosis Self-Assessment Tool for Asians (OSTA) score, smoking status, family history of fracture, diabetes mellitus, physical inactivity and T-score were considered. Test of proportions, logistic regression analysis, Hosmer-Lemeshow and Wald tests were used.
Results: Of the 184 patients, 40.2 and 29.9% have osteopenia and osteoporosis. Sixteen (21.6%) and eighteen (32.1%) osteopenic and osteoporotic men have fragility hip, spine and forearm fractures. Men 50?69 years have same risk of osteoporosis and fractures as those ³70 years. While hip fractures are higher in osteoporotic men (p < 0.05), vertebral fractures are increased in both osteopenic and osteoporotic men. Mere osteopenia predicts the presence of prevalent fractures (p < 0.05). A high risk OSTA score can predict fracture (p < 0.05). A BMI < 21 kg/m2 (p < 0.05) and current smoking (p < 0.05) are associated with osteoporosis.
Conclusion: A significant fraction of Filipino men with osteopenia and osteoporosis have prevalent fractures. Our data suggest that fractures occur in men < 70 years even before osteoporosis sets in. Low BMI, high OSTA score and smoking are significant risk factors of osteoporosis. The threshold for screening and treatment must be lowered in men contrary to the usual knowledge and practice.
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