Appropriate age to begin the risk assessment is uncertain.

Recommendation 1: American College of Physicians recommends that physicians periodically conduct individual assessment

risk factors of osteoporosis in older men (Grade: strong recommendation, moderate quality evidence). Thorough risk assessment of osteoporosis in men is important. Appropriate age to begin the risk assessment is uncertain. However, at the age of 65 years, at least 6% of men have a DXA osteoporosis, therefore, assessment of risk factors for this age is reasonable. Factors that increase the risk of osteoporosis in men include

age (70 years), low body weight (body mass index of 20 to 25 kg / m

), weight loss (10% [compared with conventional young or adult weight or weight loss in recent years]), lack of physical activity

(does not participate in physical activities on a regular basis [walking, climbing stairs, carrying weights, work on the house or gardening])

corticosteroids, androgen therapy, and previous fragility fractures. Risk assessment should be periodically updated

for men who prefer not to undergo the test. Recommendation 2: American College of Physicians recommends that physicians obtain DXA for men who are at high risk >> << osteoporosis and are candidates for drug therapy (Grade: strong recommendation, moderate quality evidence). Bone density measurement with DXA is the recognized standard for diagnosing osteoporosis in men. Men who are at increased risk of developing osteoporosis are candidates for DXA. Little evidence of DXA alternatives exist. Two most studied methods of quantitative ultrasound (usually the calcaneus) and OST. Available data indicate that none

, alternative sufficiently sensitive and specific prediction of DRA, bone mass is determined to be recommended as

to replace DXA. Although one study found a strong correlation between heel ultrasound with subsequent destruction >> << to clinical trials determine the effectiveness of treatment of osteoporosis diagnosed by ultrasound, and

than DXA, the role of ultrasound in the beginning of therapy remains uncertain. There are no lasix 12.5mg studies optimal spacing

to re-examination by the measurement of DXA. Certificate examination showed that calcaneal ultrasonography predicts DXA osteoporosis only a little good. But

More importantly, it was a strong predictor of fractures in men. This may be because ultrasound identifies other properties of bone,

, such as the quality of bone that can not be determined by DXA. Since treatment studies not measured the effectiveness of therapy >> << osteoporosis diagnosed by ultrasound, but not DXA, the role of ultrasonography in the diagnosis remains uncertain. Recommendation 3: American College of Physicians recommends further research to evaluate osteoporosis screening tests in men

. The main drawback of existing studies of osteoporosis screening is the use of BMD measurement (DRA) as the primary endpoint, and

, than fracture occurrence. Despite the large body of evidence about risk factors for osteoporosis in women, more research is needed

needed to understand whether these risk factors also relate to men. Therapy should be evaluated in terms of destruction >> << by significant disability, morbidity, mortality and costs associated with osteoporosis fractures. Also, sorry for screening in this age group, such as exposure and false-positive results, should also be studied by

. In addition, more research is needed to assess other screening tests such as quantitative computed tomography,

other profiles, or peripheral measurement defense, which may also be useful for screening in men. Next >> << studies should determine whether there are acceptable substitutes for DXA (in terms establishing the need for pharmacological therapy

). The study in question at what age people should begin to consider osteoporosis screening and effective prevention

measures for the treatment of osteoporosis in men is also necessary. .