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ISSN 0188-9796 (Impreso)

2000, Número 2

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Rev Endocrinol Nutr 2000; 8 (2)


Osteoporosis en el varón: Panorama actual

Porias CH, Barreira ME, Antunez FO, Peña RP

Idioma: Español
Referencias bibliográficas: 72
Paginas: 67-72
Archivo PDF: 175.99 Kb.


RESUMEN

El impacto físico, social, económico y psicológico de las fracturas en la mujer; ante el deterioro progresivo de su masa ósea, han sido motivo de enorme interés para médicos e investigadores básicos y clínicos. Al respecto, resulta evidente que las expectativas de vida de la población se han incrementado; debido a la mínima aplicación de la prevención de osteoporosis, particularmente en mujeres que no recibieron el apoyo oportuno durante el climaterio, han propiciado un notable incremento en la casuística de mujeres que sufren de osteoporosis en la época contemporánea. El varón también vive más y por ende, es proclive a desarrollar patologías crónicas; entre las cuales, la osteoporosis tiende a hacerse cada vez más frecuente. Sin embargo, existe una notable diferencia entre ambos sexos ya que en el hombre, la deficiencia funcional de las células de Leydig, declina gradualmente en forma paulatina y no de manera tan abrupta como sucede a nivel del aparato folicular en los ovarios. Resulta complicado establecer una estrategia diagnóstica accesible y confiable que evalúe por una parte la realidad funcional del aparato testicular; y por la otra no se ha logrado establecer con precisión el diagnóstico de osteoporosis por medio de estudios de densidad mineral ósea y/o de marcadores bioquímicos. En esta revisión se discuten los procedimientos de diagnóstico por imagen, las particularidades endocrino-hormonales y las posibles pautas terapéuticas para esta enfermedad en el varón.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Consensus development conference diagnosis, prophylaxis and treatment of osteoporosis. Am J Med 1993: 94: 646-65

  2. Lindsay Robert. The burden of osteoporosis. Cost Am J Med 1995; 98(suppl 2A): 9S-11S.

  3. Christiansen C . What should be done at the time of menopause. Am J Med 1995; 98(suppl 2A): 56S-59S.

  4. Silman AJ. The patient with fracture: The risk of subsequent fractures. Am J Med 1995: 98(suppl 2A): 12S-16S.

  5. Eberling PR. Osteoporosis in men. New insights into aetiology , pathogenesis, prevention, and management. Drugs Aging 1998; 13(6): 421-34.

  6. Siddiqui NA. Osteoporosis in older men . Discovering when and how to treat it. Geriatrics 1999; 54(9): 20-28

  7. Meier DE, Orwoll ES, Jones JM. Marked disparity between trabecular and cortical bone loss with aging healthy men: Measurement by vertebral computed tomography and radial photon absorptiometry. Ann Intern Med 1984; 101:605-612.

  8. Cooper C, Campion G, Melton LJ. Hip fractures in the elderly: A word-wide projection. Osteoporosis Int 1992; 2: 285-289.

  9. Hannan MT, Felson DT, Anderson JJ. Bone mineral density in elderly men and women: Results from the Framingham osteoporosis study. J Bone Miner Res 1992; 7: 547-553

  10. Niewoehner C. Osteoporosis in men: Is it more common than we think? Postgrad Med 1993; 93: 59-60, 63-70.

  11. Seeman E. The dilemma of osteoporosis in men . Am J Med 1995: 98: Suppl 2A: 76S-88S

  12. Mosekilde L. Age related changes in vertebral trabecular bone architecture assessed by a new method. Bone 1988; 9: 247-50.

  13. Ruff CB, Hayes WC. Sex differences in age-related remodeling of the femur and tibia. J Orthop Res 1988; 6: 886-96

  14. 14 Greenspan SL et al . Classification of osteoporosis in elderly

  15. is dependent on site-specific analysis. Calcif Tissue Int 1996;58: 409-414.

  16. Wishart JM, Need AG, Horowitz M, Nordin BEC. Effect of age on bone density and turnover in men. Clin Endocrinol 1995; 42: 141-46.

  17. Baillie SP, Davison CE. Pathogenesis of vertebral crush in men. Age Aging 1992; 21: 139-141.

  18. Katzenelson L, Finkelstein JS, Schoenfeld DA. Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism. J Clin Endocrinol Metab 1996; 81: 4358-4365.

  19. Finfelstein JS, Klibanski A, Neer RM. Increases in bone density during treatment of men with idiopathic hypogonadism. J Clin Endocrinol Metab 1989; 69: 776-783.

  20. Rudman D, Feller AG, Hoskote S. Effects of human growth hormone in men over 60 years old. N Engl J Med 1990; 323: 1-6.

  21. Marcus R, Butterfield G, Holloway L. Effects of short term administration of recombinant human growth hormone in elderly people. J Clin Endocrinol Metab 1990; 70: 519-527.

  22. Jones G, Nguyen T, Sambrook P et al. Progressive loss of bone in femoral neck in elderly people: Longitudinal findings from the Dubbo Osteoporosis Epidemiology Study. BMJ 1994; 309: 691-695.

  23. Sasano H, Uzuki M, Sawai T. Aromatase in human bone tissue. J Bone Miner Res1997; 12: 1416-1423.

  24. Orwoll ES, Meier DE. Alteration in calcium, vitamin D and parathyroid hormone physiology in normal men with aging.

  25. J Clin Endocrinol Metab 1986; 63: 1262-1269.

  26. Riggs BL, Melton LJ. Medical progress: Involutional osteoporosis. N Engl J Med 1986; 314: 1676-1686.

  27. Manolagas SC, Jika RL. Bone marrow cytokines, and bone remodeling. N Eng J Med 1995; 332: 305-311.

  28. Saez JM, Forest MG. Kinetics of human chorionic gonadotropin-induced steroidogenic response of human testis. J Clin Endocrinol Metab 1979; 49: 284-291.

  29. Salomon A, Porias H. La utilidad diagnóstica de una sola dosis de gonadotropina coriónica humana en sujetos hipogon ádicos 1982. Tesis de servicio social Departamento de ginecología endocrinológica, Unidad de Ginecoobstetricia.

  30. Hospital General de México y Universidad Autónoma de Hidalgo.

  31. Genant HK, Gordon GS, Hoffman PG. Osteoporosis part I. Assessment using quantitative computed tomography. West J Med 1983; 139: 75-84.

  32. Resh A, Schneider B. Risk of vertebral fractures in men: Relationship to mineral density of the vertebral body. AJR 1995; 164: 1447-1450.

  33. MORE STUDY. Ettinger B, et al. JAMA 1999; 282: 1-9.

  34. Rymer J, Chapman MG, Fogelman I. Effect of tibolone on postmenopausal

  35. bone loss. Osteoporosis Int 1994: 4: 1141-1146.

  36. Overgard K, Hansen MA, Christiansen C. Effects of salcatonin given intranasally on bone mass and fracture rates in established osteoporosis: A dose response study. Br Med J 1992; 305: 556-561.

  37. Black DM, Cummings SR et al. FIT 1 study. Lancet 1996; 348: 2077-2082.

  38. Oswoll ES. Osteoporosis in men. 1999 medical information services inc. 5: 2-8.

  39. Consensus development conference diagnosis, prophylaxis and treatment of osteoporosis. Am J Med 1993: 94: 646-65

  40. Lindsay Robert. The burden of osteoporosis. Cost Am J Med 1995; 98(suppl 2A): 9S-11S.

  41. Christiansen C . What should be done at the time of menopause. Am J Med 1995; 98(suppl 2A): 56S-59S.

  42. Silman AJ. The patient with fracture: The risk of subsequent fractures. Am J Med 1995: 98(suppl 2A): 12S-16S.

  43. Eberling PR. Osteoporosis in men. New insights into aetiology , pathogenesis, prevention, and management. Drugs Aging 1998; 13(6): 421-34.

  44. Siddiqui NA. Osteoporosis in older men . Discovering when and how to treat it. Geriatrics 1999; 54(9): 20-28

  45. Meier DE, Orwoll ES, Jones JM. Marked disparity between trabecular and cortical bone loss with aging healthy men: Measurement by vertebral computed tomography and radial photon absorptiometry. Ann Intern Med 1984; 101:605-612.

  46. Cooper C, Campion G, Melton LJ. Hip fractures in the elderly: A word-wide projection. Osteoporosis Int 1992; 2: 285-289.

  47. Hannan MT, Felson DT, Anderson JJ. Bone mineral density in elderly men and women: Results from the Framingham osteoporosis study. J Bone Miner Res 1992; 7: 547-553

  48. Niewoehner C. Osteoporosis in men: Is it more common than we think? Postgrad Med 1993; 93: 59-60, 63-70.

  49. Seeman E. The dilemma of osteoporosis in men . Am J Med 1995: 98: Suppl 2A: 76S-88S

  50. Mosekilde L. Age related changes in vertebral trabecular bone architecture assessed by a new method. Bone 1988; 9: 247-50.

  51. Ruff CB, Hayes WC. Sex differences in age-related remodeling of the femur and tibia. J Orthop Res 1988; 6: 886-96

  52. 14 Greenspan SL et al . Classification of osteoporosis in elderly is dependent on site-specific analysis. Calcif Tissue Int 1996;58: 409-414.

  53. Wishart JM, Need AG, Horowitz M, Nordin BEC. Effect of age on bone density and turnover in men. Clin Endocrinol 1995; 42: 141-46.

  54. Baillie SP, Davison CE. Pathogenesis of vertebral crush in men. Age Aging 1992; 21: 139-141.

  55. Katzenelson L, Finkelstein JS, Schoenfeld DA. Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism. J Clin Endocrinol Metab 1996; 81: 4358-4365.

  56. Finfelstein JS, Klibanski A, Neer RM. Increases in bone density during treatment of men with idiopathic hypogonadism. J Clin Endocrinol Metab 1989; 69: 776-783.

  57. Rudman D, Feller AG, Hoskote S. Effects of human growth hormone in men over 60 years old. N Engl J Med 1990; 323: 1-6.

  58. Marcus R, Butterfield G, Holloway L. Effects of short term administration of recombinant human growth hormone in elderly people. J Clin Endocrinol Metab 1990; 70: 519-527.

  59. Jones G, Nguyen T, Sambrook P et al. Progressive loss of bone in femoral neck in elderly people: Longitudinal findings from the Dubbo Osteoporosis Epidemiology Study. BMJ 1994; 309: 691-695.

  60. Sasano H, Uzuki M, Sawai T. Aromatase in human bone tissue. J Bone Miner Res1997; 12: 1416-1423.

  61. Orwoll ES, Meier DE. Alteration in calcium, vitamin D and parathyroid hormone physiology in normal men with aging. J Clin Endocrinol Metab 1986; 63: 1262-1269.

  62. Riggs BL, Melton LJ. Medical progress: Involutional osteoporosis. N Engl J Med 1986; 314: 1676-1686.

  63. Manolagas SC, Jika RL. Bone marrow cytokines, and bone remodeling. N Eng J Med 1995; 332: 305-311.

  64. Saez JM, Forest MG. Kinetics of human chorionic gonadotropin-induced steroidogenic response of human testis. J Clin Endocrinol Metab 1979; 49: 284-291.

  65. Salomon A, Porias H. La utilidad diagnóstica de una sola dosis de gonadotropina coriónica humana en sujetos hipogon ádicos 1982. Tesis de servicio social Departamento de ginecología endocrinológica, Unidad de Ginecoobstetricia. Hospital General de México y Universidad Autónoma de Hidalgo.

  66. Genant HK, Gordon GS, Hoffman PG. Osteoporosis part I. Assessment using quantitative computed tomography. West J Med 1983; 139: 75-84.

  67. Resh A, Schneider B. Risk of vertebral fractures in men: Relationship to mineral density of the vertebral body. AJR 1995; 164: 1447-1450.

  68. MORE STUDY. Ettinger B, et al. JAMA 1999; 282: 1-9.

  69. Rymer J, Chapman MG, Fogelman I. Effect of tibolone on postmenopausal bone loss. Osteoporosis Int 1994: 4: 1141-1146.

  70. Overgard K, Hansen MA, Christiansen C. Effects of salcatonin given intranasally on bone mass and fracture rates in established osteoporosis: A dose response study. Br Med J 1992; 305: 556-561.

  71. Black DM, Cummings SR et al. FIT 1 study. Lancet 1996; 348: 2077-2082.

  72. Oswoll ES. Osteoporosis in men. 1999 medical information services inc. 5: 2-8.




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