Causes of osteoporosis in males - A review of 160 cases

Background. The discovery of osteoporosis in a male requires a careful sear ch for a cause. Objective. To evaluate etiologic factors in male osteoporos is. Patients and methods. Males admitted to our department for osteoporosis were included if they had a nontrauma-related vertebral or peripheral frac ture and/or a spinal or femoral neck bone mineral density value 2.5 standar d deviations or more below the mean in young subjects. The study was retros pective from 1990 to 1995 and prospective from 1996 to 1997. During the pro spective part of the study. each subject underwent a standardized battery o f laboratory tests including renal tubular function parameters. Causes iden tified during these two periods were compared. Results. Of the 160 patients included in the study, 28.1% had idiopathic osteoporosis, 22.5% had alcoho lic osteoporosis, 19.4% had glucocorticoid-induced osteoporosis, 12.8% had osteoporosis due to moderate idiopathic proximal tubule dysfunction, and 8. 8% had senile osteoporosis. The proportion of patients with idiopathic oste oporosis was 30% (23/76) during the retrospective part of the study and 26% (21/84) during the prospective part (nonsignificant difference). Moderate idiopathic proximal tubule dysfunction was found in 2.6% (2/76) and 21.4% ( 18/84) of patients during these two parts of the study, respectively, a dif ference ascribable to the routine determination of tubule function paramete rs during the second part of the study. Conclusion. An exhaustive search fo r a cause decreases the proportion of male osteoporosis cases that remain i diopathic. In our study, only 28% of cases were classified as idiopathic, a term that probably indicates involvement of multiple interrelated factors.