For millions of American men, osteoporosis is, unfortunately, an often overlooked disease that may be "silent" until a fracture occurs. These fractures are a major public health threat. After age 30, when peak bone mass is attained, our bones start to lose density and strength. This bone loss affects women more than men, who have larger, stronger bones. But men, too, are at risk.
Scientists at the Institute for Aging Research of Hebrew SeniorLife have conducted studies to determine the effects of sex hormones such as estrogen and testosterone on bone mineral density in men. One study found that men with low levels of estradiol (the predominant femal e sex hormone and a major form of estrogen) are at increased risk for hip fractures. Further, men with low estradiol and low testosterone are at greatest risk for hip fracture. An earlier Institute study supports growing evidence that serum estradiol (the amount of estradiol found in the blood) plays a significant biological role in the bone health of men.
These findings are important because up to 50 percent of men who suffer a hip fracture, a significant complication of osteoporosis, will need institutionalized care. Many who do return home after a hip fracture are unable to regain the level of function they had before their injury. Men suffer about 30 percent of all hip fractures and have higher death rates following hip fracture than women.
Douglas P. Kiel, M.D., M.P.H., a leading osteoporosis researcher at the Institute for Aging Research, is conducting a clinical trial of a new drug, odanacatib, to see what effect it has on preventing osteoporotic fractures in men. Odanacatib is an investigational drug that blocks the activity of an enzyme that causes bones to break down.
Dr. Kiel says the identification of both men and women with low bone density and those at risk of falls are the best fracture prevention strategies.