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Men's Health: Scoring system identifies men at risk for osteoporosis

Low body weight proves to be a key predictor of brittle bones in men over age 50

A simple scoring system can help predict which men might be at risk for fractures due to osteoporosis and should get a bone density scan.

Osteoporosis, or brittle bones, is more common in women, but one in eight men over age 50 also has the condition. It can be detected by a test called dual energy X-ray absorptiometry (DXA), also known as a bone density scan.

“The objective of our study was to develop and validate a tool to identify which men might benefit from a DXA, because you can’t afford to DXA everybody,” says Dr. Angela Shepherd of the University of Texas Medical Branch in Galveston.

The Male Osteoporosis Risk Estimation Score (MORES) consists of only five questions, but can identify 90 per cent of osteoporosis cases while calling for DXA scans on only about one-third of men age 50 and over.

Shepherd and her colleagues analysed risk factors for osteoporosis, such as age, weight, alcohol use, smoking, education, health status, chronic lung disease and marital status, in a group of nearly 3,000 men.

The factors that proved to be the most significant were age, weight, single marital status, tobacco use and not drinking alcohol.

The identification of not drinking alcohol as a risk factor was surprising, because alcohol is toxic to bone, Shepherd says. “It makes no sense. We think it stands for something else. Maybe it stands for people who used to be alcoholics and now don’t drink at all.”

In the final MORES scoring system, a body weight of 70 kilograms or less proved to be the most important factor. Any man age 50 and older in that weight range is considered at risk for osteoporosis by the scoring system.

Canadian guidelines recommend screening men for osteoporosis at age 65.