DETERMINANTS OF BONE-MINERAL DENSITY IN OLDER MEN

Osteoporosis is a significant health problem and contributor to disabi lity and premature mortality among older men. Incidence rates for hip fracture have stabilized in women, but continue to increase in men. A major risk factor for hip fracture is bone mineral density level, The determinants of bone mineral density (BMD) are well defined in women, but not in men. The primary goal of the current research was to increa se our understanding of the determinants of BMD of the proximal femur in a large community-based sample of older male volunteers. Eligibilit y requirements included age of 50 years or older, ambulatory, and not having undergone a bilateral hip replacement. Five hundred twenty-thre e men, mean age 66.6 years, met all eligibility requirements and parti cipated in the Study of Osteoporotic Risk in Men or STORM. Information on demographics, medical history, anthropometry, leisure-time and occ upational physical activity, muscular strength, cigarette smoking, alc ohol consumption, dietary calcium intake, and medication use (thiazide diuretics and glucocorticoids) were obtained by questionnaire, interv iew, and examination. BMD of the proximal femur (femoral neck, greater trochanter, and Ward's triangle) was measured by dual-energy X-ray ab sorptiometry using the Hologic QDR-1000 and QDR-2000. The cross-sectio nal determinants of BMD included age, blond hair color, current body w eight, thiazide diuretic use, historical physical activity, and quadri ceps strength. Several variables commonly thought to be determinants o f BMD were not related to BMD in this population of older men, includi ng current cigarette smoking, alcohol consumption, current leisure-tim e physical activity, dietary calcium intake, vitamin D use, and caffei ne intake. However, failure to find associations among BMD and some of the potential determinants may be due to lack of statistical power. I dentification of the determinants of BMD could lead to the development of interventions aimed at maximizing BMD in men and could potentially decrease the risk of hip fractures.