20 October 2010
Lucknow, India
Even men are at risk of Brittle Bones
Bones of some 20% males defeat them in the fifth decade of life. Worse, nine out of ten men are not even aware of the risk osteoporosis poses to them. A report by Shailvee Sharda
‘‘A vast majority of urban patients diagnosed osteoporosis have the rarest idea of it. And lack of awareness makes men carefree and they end up breaking their bones,’’ said said Dr RN Srivastava of CSMMU. He added that coming to know of the disease is purely incidental – usually during an episode of fracture caused by trauma (road accident).
Few who know the name, may because of some female patient in the family, show signs of disbelief. ‘‘How can this happen to me?’’, is how they react. ‘‘Even worse is that men do not recognise a fracture as an indicator of osteoporosis or the risk of further fractures, which is critical,’’ said Dr Ajai Singh who works with Dr Srivastava.
To note, osteoporosis is characterised by a progressive loss of bone minerals, giving bones a spongy appearance, making them more prone to breaking.
More local evidences are available to show poor bone health and poorer awareness. Initial degeneration of bones, technically known as osteopenia, is an important proof of weakening bones. A research paper presented by Dr Ajai Singh and his team showed that the cause of pain in 23% of the men suffering with backache was osteoporosis.
And 89% of graduates taken in the study had ruled out the possibility of their condition being a result of osteoporosis. Though the sample size was small, but it prompts to work for more awareness. Department of rheumatology, Government General Hospital, Chennai did a more planned study. Citing this study, Dr Srivastava said, ‘‘Two of their findings are significant. First, osteoporosis is affecting the younger men and women (18–45 years age bracket). And second, equal number of men and women (average of 35%) suffered from osteopenia.’’
Orthopaedicians warn that individuals enslaved by fast food and sedentary lifestyle are at a greater risk of falling prey to the disease (says a study published in British Journal of Orthopaedics). This holds more true for men than women.
It may, however, be underlined that the observation is yet to be quantified scientifically in the context of Lucknow.
Orthopaedicians world over say that the main determinants of strong and healthy bones are nutrition, genetics, lifestyle and hormones. While, there is little control over genetic factors, others can be managed.
Citing the lead author, Kerrin Bleicher, Dr Srivastava attributed lack of awareness partly because of the age–old perception that ‘osteoporosis is a women’s disease’. ‘‘The same holds true for Lucknow also. At this point of time, orthopaedicians must rise to redefine osteoporosis and chisel a new perception for it,’’ he said.
The scenario in Lucknow is representative of the global picture as well. The latest study undertaken by Australian researchers also shows that over nine in ten men who suffered from osteoporosis were not aware of their condition. It also said that extent could be higher in the general population.
Expert groups peg the number of osteoporosis patients at approximately 26 million with the numbers projected to increase to 36 million by 2013. Studies show that Indian population is at the higher risk of osteopenia which would eventually translate into osteoporosis.
Risk For Men
Lower prevalence | Risk of experiencing an osteoporotic fracture above 50 years of age is 30% – similar to the lifetime risk of prostate cancer.
Higher mortality | Although the overall prevalence of fragility fractures is higher in women, men generally have higher rates of fracture related mortality. The overall mortality is about 20% in the first year after hip fracture, which increases with age.
Bones under threat | Though long bones are at a greater risk of breaking, hip fractures may make life miserable. Men share about 20–25% of total hip fractures burden in India, causing significant morbidity and loss of normal functioning.
Early & warning signs | Forearm fracture is an early and sensitive marker of male skeletal fragility. In aging men, wrist fractures carry a higher absolute risk for hip fracture than spinal fractures in comparison to women. If one is suffering with unexplained vague pain in the body especially in the back and joints. Or, if one suffers a fracture from an insignificant or trivial injury.
Testing Facilities | A BMD testing camp is organised by CSMMU’S orthopaedic department at its OPD (Regional limb centre, Daliganj, Lucknow) on Mondays. The BMD testing is done here free of cost. CSMMU’s rheumatology department also has the facility of measuring BMD. It, however, charges for the services, though the cost has been subsidised. SGPGIMS also has the facility besides several private diagnostic centres.
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