ETIOLOGY AND PRESENTING SYMPTOMS IN MALE OSTEOPOROSIS

In order to analyse the clinical characteristics and the principal cau ses of osteoporosis in men. 81 osteoporotic males from an out-patient rheumatology department were studied. Bone mass assessment? automated biochemical profile and biochemical markers of bone turnover were perf ormed in all patients, and hormonal measurements were taken when a spe cific aetiology was not readily apparent. Sixty-three men (78%) had se condary osteoporosis and 18 (22%) primary osteoporosis. Secondary caus es of osteoporosis included hypogonadism (12 patients). corticosteroid therapy (10 patients) and alcoholism (10 patients); the remaining pat ients had various causes of osteoporosis. Eighteen patients had primar y osteoporosis, eight of them with associated hypercalciuria. Normocal ciuric patients showed lower 25-hydroxyvitamin D and 1-25-hydroxyvitam in D levels than the control group, whereas hypercalciuric patients ha d lower parathyroid hormone and renal threshold for phosphate excretio n. In 69 patients (85%), back pain was the chief complaint. Forty-five of these 69 patients (65%) had chronic back pain and 24 (35%) had sub acute episodes. Fifty per cent of the patients with chronic back pain had vertebral fractures. Both patients with and without chronic back p ain were found to have a similar number of vertebral fractures. In con clusion, male osteoporosis is frequently associated with major risk fa ctors. Patients with primary osteoporosis may have associated hypercal ciuria or decreased vitamin D levels. However, not all the patients fo r whom back pain was the chief complaint were found to have vertebral fractures.