SAN ANTONIO — If you want to identify the male patients who are most likely to have osteoporosis, look for the thin ones, and then ask them about their calcium intake, Bryan R. Whelan, M.D., said at the annual meeting of the American College of Rheumatology.
Dr. Whelan and his colleagues prospectively screened 350 men referred to an osteoporosis clinic in Cork, Ireland, for assessment using dual x-ray absorptiometry. The aim was to retrospectively assess whether the patients were being properly referred and to identify what, if any, clinical characteristics were associated with a higher risk for fracture.
Overall, 45% of the patients were found to have osteopenia or osteoporosis. Weight turned out to be the most important predictor of who had low bone density, even more so than corticosteroid treatment, said Dr. Whelan of the department of medicine, University College of Cork.
Although 39% of the patients were on or had received corticosteroid treatment, which was why they received the referral, steroid treatment was not correlated with a significantly higher likelihood of a low T score or z score in the study, Dr. Whelan said.
Individuals with a body mass index of less than 25 kg/mg
Patients completed questionnaires on lifestyle factors, such as whether they smoked, how much alcohol they consumed, and the amount of their calcium intake. Participants who took a calcium supplement, ate two or more serving of cheese a day, or drank at least a pint of milk a day were considered to have an adequate calcium intake.
Among men with low BMI and inadequate calcium intake, 70% were found to have a low z score.
“Even though we used such a crude tool to define adequate versus inadequate [calcium intake], it did stratify” patients by their risk, he said.
Even age and daily exercise, which were somewhat related to risk, were not as highly predictive, Dr. Whelan said.