Introduction: Causes and Risk Factors for Male Osteoporosis

Abstract

Although osteoporosis has long been mislabeled as a women’s disease, during the last decades the scientific community has acknowledged that male osteoporosis also represents an important public health and economic issue, being responsible for an increased risk of fragility fractures which show a particularly poor prognosis in men. Specifically, osteoporosis in men is a heterogeneous condition with several causes, well beyond the established age-related gonadal, muscular, and nutritional changes. In fact, the pathophysiology of the disease in some cases described as “idiopathic” can be even backdated to genetic and/or environmental factors occurring during pre-pubertal and pubertal growth periods that are crucial for the acquisition of peak bone mass. Moreover, secondary causes account for almost 40% of cases of male osteoporosis, with the most common etiologies represented by glucocorticoid excess, hypogonadism, alcohol abuse, calcium malabsorption, and vitamin D deficiency. Therefore, an early identification of the main causes underlying this disorder is essential in order to guarantee an adequate management of the disease and its related fracture risk, as well as to maintain quality of life.