TY - JOUR
T1 - Risk factors for low bone mass-related fractures in men
T2 - A systematic review and meta-analysis
AU - Drake, Matthew T.
AU - Murad, Mohammad Hassan
AU - Mauck, Karen F.
AU - Lane, Melanie A.
AU - Undavalli, Chaitanya
AU - Elraiyah, Tarig
AU - Stuart, Louise M.
AU - Prasad, Chaithra
AU - Shahrour, Anas
AU - Mullan, Rebecca J.
AU - Hazem, Ahmad
AU - Erwin, Patricia J.
AU - Montori, Victor M.
PY - 2012/6
Y1 - 2012/6
N2 - Context: Testing men at increased risk for osteoporotic fractures has been recommended. Objective: The aim of this study was to estimate the magnitude of association and quality of supporting evidence linking multiple risk factors with low bone mass-related fractures in men. Data Sources: We searched MEDLINE, EMBASE, Web of Science, SCOPUS and Cochrane CENTRAL through February 2010. We identified further studies by reviewing reference lists from selected studies and reviews. Study Selection: Eligible studies had to enroll men and quantitatively evaluate the association of risk factors with low bone density-related fractures. Data Extraction: Reviewers working independently and in duplicate determined study eligibility and extracted study description, quality, and outcome data. Data Synthesis: Fifty-five studies provided data sufficient for meta-analysis. The quality of these observational studies was moderate with fair levels of multivariable adjustment and adequate exposure and outcome ascertainment. Statistically significant associations were established for age, low body mass index, current smoking, excessive alcohol use, chronic corticosteroid use, history of prior fractures, history of falls, history of hypogonadism, history of stroke, and history of diabetes. Statistical heterogeneity of the meta-analytic estimates of all associations was significant except for chronic corticosteroid use. None of these associations were of large magnitude (i.e. adjusted odds ratios were generally <2). No evidence supporting a particular effective testing or screening strategy was identified. Conclusions: Multiple risk factors for fractures in men were identified, but their usefulness for stratifying and selecting men for bone density testing remains uncertain.
AB - Context: Testing men at increased risk for osteoporotic fractures has been recommended. Objective: The aim of this study was to estimate the magnitude of association and quality of supporting evidence linking multiple risk factors with low bone mass-related fractures in men. Data Sources: We searched MEDLINE, EMBASE, Web of Science, SCOPUS and Cochrane CENTRAL through February 2010. We identified further studies by reviewing reference lists from selected studies and reviews. Study Selection: Eligible studies had to enroll men and quantitatively evaluate the association of risk factors with low bone density-related fractures. Data Extraction: Reviewers working independently and in duplicate determined study eligibility and extracted study description, quality, and outcome data. Data Synthesis: Fifty-five studies provided data sufficient for meta-analysis. The quality of these observational studies was moderate with fair levels of multivariable adjustment and adequate exposure and outcome ascertainment. Statistically significant associations were established for age, low body mass index, current smoking, excessive alcohol use, chronic corticosteroid use, history of prior fractures, history of falls, history of hypogonadism, history of stroke, and history of diabetes. Statistical heterogeneity of the meta-analytic estimates of all associations was significant except for chronic corticosteroid use. None of these associations were of large magnitude (i.e. adjusted odds ratios were generally <2). No evidence supporting a particular effective testing or screening strategy was identified. Conclusions: Multiple risk factors for fractures in men were identified, but their usefulness for stratifying and selecting men for bone density testing remains uncertain.
UR - http://www.scopus.com/inward/record.url?scp=84861992896&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84861992896&partnerID=8YFLogxK
U2 - 10.1210/jc.2011-3058
DO - 10.1210/jc.2011-3058
M3 - Article
C2 - 22466344
AN - SCOPUS:84861992896
SN - 0021-972X
VL - 97
SP - 1861
EP - 1870
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 6
ER -