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Men's Osteopenia Dx Unlikely to Change at 3 Years

HONOLULU — Men diagnosed with osteopenia through dual-energy x-ray absorptiometry are unlikely to have a change in diagnosis at a 3-year follow-up DXA test, according to a study presented in a poster at the annual meeting of the American Society for Bone and Mineral Research.

“The interval for a follow-up bone density should be lengthened, or perhaps the repeat DXA should not be done unless there is an additional risk factor noted,” wrote Dr. Robert A. Adler of the endocrinology section of McGuire Veterans Affairs Medical Center and Virginia Commonwealth University, Richmond, and his colleagues. Increased risk for developing osteoporosis could, for example, be a concern for prostate cancer patients on androgen deprivation therapy.

The researchers followed 78 men with osteopenia (T score of lumbar spine, femoral neck, total hip, total forearm or distal 1/3 forearm between −1 and −2.4) from a baseline DXA test through follow-up DXA testing an average of 998 days later. Mean age and weight at baseline were 70.7 years and 76.4 kg, respectively.

The men, patients from primary care practices at a Veterans Affairs medical center, had been referred for an initial DXA test after a screening program using the Osteoporosis Self-Assessment Tool had found them to be at greater risk for osteoporosis.

Mean percent changes in bone mineral density (BMD) from baseline to follow-up were 1.8% for lumbar spine, −0.4% for femoral neck, −0.7% for total hip, −1.1% for 1/3 radius, and −1.6% for total forearm.

“The BMD changes were minimal, approximately plus or minus 2%,” the researchers noted, and affected diagnosis very rarely: Only one patient started therapy for osteoporosis after the follow-up DXA test because of a significant change in BMD.

Although the patients were advised at diagnosis with osteopenia to begin taking calcium and vitamin D supplements, only about one-fourth to one-third of the 78 actually received the supplementation after the baseline DXA test. But after the second DXA, “an additional 17 men were prescribed supplements,” the authors wrote.

Although these results suggest a second DXA test may encourage clinicians to prescribe such preventive measures for their patients, “there should be cheaper ways to improve clinician behavior,” wrote the authors. Dr. Adler said he had no conflicts of interest to disclose.

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HONOLULU — Men diagnosed with osteopenia through dual-energy x-ray absorptiometry are unlikely to have a change in diagnosis at a 3-year follow-up DXA test, according to a study presented in a poster at the annual meeting of the American Society for Bone and Mineral Research.

“The interval for a follow-up bone density should be lengthened, or perhaps the repeat DXA should not be done unless there is an additional risk factor noted,” wrote Dr. Robert A. Adler of the endocrinology section of McGuire Veterans Affairs Medical Center and Virginia Commonwealth University, Richmond, and his colleagues. Increased risk for developing osteoporosis could, for example, be a concern for prostate cancer patients on androgen deprivation therapy.

The researchers followed 78 men with osteopenia (T score of lumbar spine, femoral neck, total hip, total forearm or distal 1/3 forearm between −1 and −2.4) from a baseline DXA test through follow-up DXA testing an average of 998 days later. Mean age and weight at baseline were 70.7 years and 76.4 kg, respectively.

The men, patients from primary care practices at a Veterans Affairs medical center, had been referred for an initial DXA test after a screening program using the Osteoporosis Self-Assessment Tool had found them to be at greater risk for osteoporosis.

Mean percent changes in bone mineral density (BMD) from baseline to follow-up were 1.8% for lumbar spine, −0.4% for femoral neck, −0.7% for total hip, −1.1% for 1/3 radius, and −1.6% for total forearm.

“The BMD changes were minimal, approximately plus or minus 2%,” the researchers noted, and affected diagnosis very rarely: Only one patient started therapy for osteoporosis after the follow-up DXA test because of a significant change in BMD.

Although the patients were advised at diagnosis with osteopenia to begin taking calcium and vitamin D supplements, only about one-fourth to one-third of the 78 actually received the supplementation after the baseline DXA test. But after the second DXA, “an additional 17 men were prescribed supplements,” the authors wrote.

Although these results suggest a second DXA test may encourage clinicians to prescribe such preventive measures for their patients, “there should be cheaper ways to improve clinician behavior,” wrote the authors. Dr. Adler said he had no conflicts of interest to disclose.

HONOLULU — Men diagnosed with osteopenia through dual-energy x-ray absorptiometry are unlikely to have a change in diagnosis at a 3-year follow-up DXA test, according to a study presented in a poster at the annual meeting of the American Society for Bone and Mineral Research.

“The interval for a follow-up bone density should be lengthened, or perhaps the repeat DXA should not be done unless there is an additional risk factor noted,” wrote Dr. Robert A. Adler of the endocrinology section of McGuire Veterans Affairs Medical Center and Virginia Commonwealth University, Richmond, and his colleagues. Increased risk for developing osteoporosis could, for example, be a concern for prostate cancer patients on androgen deprivation therapy.

The researchers followed 78 men with osteopenia (T score of lumbar spine, femoral neck, total hip, total forearm or distal 1/3 forearm between −1 and −2.4) from a baseline DXA test through follow-up DXA testing an average of 998 days later. Mean age and weight at baseline were 70.7 years and 76.4 kg, respectively.

The men, patients from primary care practices at a Veterans Affairs medical center, had been referred for an initial DXA test after a screening program using the Osteoporosis Self-Assessment Tool had found them to be at greater risk for osteoporosis.

Mean percent changes in bone mineral density (BMD) from baseline to follow-up were 1.8% for lumbar spine, −0.4% for femoral neck, −0.7% for total hip, −1.1% for 1/3 radius, and −1.6% for total forearm.

“The BMD changes were minimal, approximately plus or minus 2%,” the researchers noted, and affected diagnosis very rarely: Only one patient started therapy for osteoporosis after the follow-up DXA test because of a significant change in BMD.

Although the patients were advised at diagnosis with osteopenia to begin taking calcium and vitamin D supplements, only about one-fourth to one-third of the 78 actually received the supplementation after the baseline DXA test. But after the second DXA, “an additional 17 men were prescribed supplements,” the authors wrote.

Although these results suggest a second DXA test may encourage clinicians to prescribe such preventive measures for their patients, “there should be cheaper ways to improve clinician behavior,” wrote the authors. Dr. Adler said he had no conflicts of interest to disclose.

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