The findings, which were presented at the fifth “Pan-Arab Osteoporosis Congress” in Damascus on April 29, came to a surprise to many, since osteoporosis is more commonly seen in post-menopausal women.
According to the International Foundation of Osteoporosis in the US, the prevalence of the disease among white males is seven percent and five percent in African-American men, compared to 30 percent among post-menopausal white women.
“Osteoporosis, which literally means ‘porous bone,’ is a disease in which the density and quality of bones are reduced,” states the website of the International Foundation of Osteoporosis. The loss of bone occurs progressively and without warning and there are no symptoms until the first fracture occurs. As a result, fractures are a major cause of pain and disability and are even associated with a high mortality rate.
“Osteoporosis is a hidden disease in men, but from my own study, you can see that the condition could be affecting a significant number of older Arab males in the UAE. The majority of these men will not even know they have the disease and may already have fractures that can lead to serious disability and an increased risk of death,” warns Dr. Haider Al Attia, a consultant in Internal Medicine and Rheumatology at Al Noor Hosptial in Abu Dhabi.
In Al Attia’s study, he tested the density of the femur bone in140 predominantly Arab male patients aged 55 years and over — who were attending hospital for the treatment of other conditions — to determine the prevalence of osteoporosis in this group. The research, using Dual-Energy X-ray Absorptiometry (DEXA), found that between 22 percent of men aged 55 and over, and 34 percent of those over the age of 64 years, were suffering from the bone disease.
Another study presented by Al Attia at the conference, underscores the high risk among men with osteoporosis of developing an osteoporotic fracture. Using the hospital’s fracture registry, he examined the prevalence of fragility fractures in males and females during a 30-month period.
Results showed that 41 percent of the 37 documented fragility fractures were in men and 59 percent in women, which is similar to US figures from the International Foundation of Osteoporosis that estimate that 61 percent of osteoporotic fractures occur in women compared to 39 percent in men.
“Despite osteoporosis being more common in women, our study highlights the fact that if you are a male with osteoporosis, then you are just as likely as women to suffer from a fragility fracture. Early diagnosis and treatment of osteoporosis is essential because after one fracture, there is a five to 10-fold increase in the risk of suffering a second fracture within one year and a two-fold increase in risk of hip fracture, with a resulting rise in the chance of suffering from disability and death,” said Al Attia.
The development of osteoporosis in men is primarily associated with age and genetic pre-disposition to the disease. However, there are a number of other factors that increase the risk including: treatment with glucocorticoid steroids, anticonvulsants, Vitamin D deficiency, chronic liver and kidney disease, smoking, excess alcohol intake, low levels of androgens (such as testosterone) and low levels of oestrogen.
Bisphosphonates are the main form of treatment for osteoporosis in both men and women. They are taken weekly or monthly orally, or via an infusion that only has to be administered once a year, which can help improve medication compliance.
“Doctors in the UAE have all kinds of medications within accessible reach which they can use to treat osteoporosis. Both men and women should be benefiting from these treatments. Osteoporosis should always be investigated when caring for elderly patients, and it is vital that health providers and health educators in the UAE start to raise awareness for this debilitating disease among men,” added Al Attia.
The fifth “Pan-Arab Osteoporosis Congress” in Syria took place from April 28 to 30 at the Four Seasons Hotel in Damascus, under the patronage of Mrs. Asma Assad — The First Lady of the Syrian Arab Republic — in association with the International Foundation of Osteoporosis.
