ETIOLOGIC FEATURES OF OSTEOPOROSIS IN MALE-PATIENTS AGED LESS-THAN 50- STUDY OF 28 CASES WITH A COMPARATIVE SERIES OF 30 PATIENTS MORE THAN 50 YEARS OF AGE

Purpose. - To study the aetiologic factors of osteoporosis (OP) in you ng male patients, we conducted a retrospective study of male osteoporo sis observed in our department during the past 20 years. Methods. - Pa tients included in the study were over 16 years of age and had a fract ure or a decreased bone mineral density with a T score (assessed at th e spine or at the spine and femoral neck) below -2.5 SD. The age and c ircumstances of diagnosis, serum and 24-hour urinary calcium and phosp horus investigations, hormonal measurements (including parathyroid hor mone, thyroid hormones, cortisol and testosterone), bone biopsy and th e final diagnosis were analyzed. Results. - One hundred and nineteen p atients responded to the defined diagnosis criteria. Twenty-eight were less than 50 years of age (group I or young male osteoporosis). Data were compared with those of 30 patients more than 50 years of age (gro up II). In group I, an aetiology was found in 17 out of 28 cases (60.7 %) (secondary osteoporosis : OP II), while 11 out of 28 patients (39.3 %) had primary or idiopathic osteoporosis (OP I). In group II, the fre quency of OP I was 19 out of 30 cases (63.3%) and 11 out of 30 patient s (36.6%) had OP II. However, the frequency of OP II did not differ si gnificantly between the two groups (P = 0.11). The aetiology in group I was either hypogonadism (6 out of 17), alcoholism (2 out of 17), mas tocytosis (2 out of 17), primary biliary cirrhosis (I out of 17), oste ogenesis imperfecta (1 out of 17), idiopathic hypercalciuria (1 out of 17), corticosteroid treatment (1 out of 17) or ankylosing spondylitis (1 out of 17). Multiple causes were found in 5 out of 17 cases. The c auses of osteoporosis in group II included hypogonadism (2 out of 11), alcoholism (2 out of 11), idiopathic hypercalciuria (2 out of 11), gl ucocorticosteroid therapy (6 out of II) and rheumatoid arthritis (1 ou t of 11). Conclusions. - Our results were compared to those of the var ious series reported in the literature which, though focusing on male osteoporosis, often included elderly patients. To determine whether os teoporosis in young male is more often OP II, further prospective stud ies are required. (C) 1998, Elsevier, Paris.