Liu H et al. - Key risk factors for low BMD–mediated fracture include increased age, low body weight, weight loss, physical inactivity, prolonged corticosteroid use, previous osteoporotic fracture, and androgen deprivation therapy. Non- dual-energy x-ray absorptiometry (DXA) tests either are too insensitive or have insufficient data to reach conclusions. Methods
Aim was to identify which asymptomatic men should receive DXA BMD testing
A systemic review evaluated 1) risk factors for osteoporotic fracture in men with low BMD and 2) the performance of non-DXA tests in identifying men with low BMD
Studies identified through the MEDLINE database
Articles that assessed risk factors for osteoporotic fracture in men or evaluated a non-DXA screening test
Results
167 studies found high-risk factors to be increased age (>70 yrs), low body weight <20-25 kg/m2), weight loss (>10%), physical inactivity, prolonged corticosteroid use, and previous osteoporotic fracture
An additional 102 studies assessing 15 other proposed risk factors
Most had insufficient evidence in men to draw conclusions
20 diagnostic study articles were reviewed
Calcaneal ultrasonography had a sensitivity of 75% and specificity of 66% for identifying DXA-determined osteoporosis
Osteoporosis Self-Assessment Screening Tool had a sensitivity of 81% and specificity of 68% to identify DXA-determined osteoporosis
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