Documento de consenso de osteoporosis del varón / Consensus document on osteoporosis in males

Objetivo Proporcionar unas recomendaciones prácticas para la evaluación y tratamiento de la osteoporosis del varón. Participantes Miembros del Grupo de Metabolismo Mineral de la Sociedad Española de Endocrinología y Nutrición. Métodos Las recomendaciones se formularon de acuerdo con el sistema Grading of Recommendations, Assessment, Development and Evaluation (GRADE) para establecer tanto la fuerza de las recomendaciones como el grado de evidencia. Se realizó una búsqueda sistemática en Medline de la evidencia disponible sobre la osteoporosis del varón usando las siguientes palabras claves asociadas: osteoporosis, men, fractures, bone mineral density, treatment, hypogonadism y prostate cancer. Se revisaron artículos escritos en inglés y español con fecha de inclusión hasta el 30 de agosto del 2017; cada tema fue revisado por 2 personas del grupo. Tras la formulación de las recomendaciones, estas se discutieron en una reunión conjunta del grupo de trabajo. Conclusiones El documento establece unas recomendaciones prácticas basadas en la evidencia acerca del diagnóstico, evaluación y tratamiento de la osteoporosis del varón y situaciones especiales como el hipogonadismo y el tratamiento con terapia de déficit androgénico en el carcinoma de próstata.

Objective To provide practical recommendations to assess and treat osteoporosis in males. Participants Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. Methods Recommendations were formulated using the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in Medline (PubMed) using the following associated terms: «osteoporosis¼, «men¼, «fractures¼, «bone mineral density¼, «treatment¼, «hypogonadism¼, and «prostate cancer¼. Papers in English and Spanish with publication date before 30 August 2017 were included. Current evidence for each disease was reviewed by 2 group members. Finally, recommendations were discussed in a meeting of the working group. Conclusions The document provides evidence-based practical recommendations for diagnosis, assessment, and management of osteoporosis in men and special situations such as hypogonadism and prostate cancer.

Ischemic heart disease is associated with vertebral fractures in patients with type 2 diabetes mellitus.

AIMS/INTRODUCTION: Discordant results about the relationship between diabetes complications and the risk of fragility fractures have been reported. Our aims were to analyze the factors related to morphometric vertebral fractures (VFs) in patients with type 2 diabetes mellitus, and to explore the association between the presence of VFs and the main cardiovascular risk factors. MATERIALS AND METHODS: We carried out a cross-sectional study including 123 patients with type 2 diabetes mellitus, and in 72 of these patients we recorded data about the risk factors for VFs and comorbidities of diabetes including diabetes-related microvascular disease and cardiovascular disease. RESULTS: In the crude analysis, diabetic retinopathy (odds ratio [OR] 4.09, 95% confidence interval [CI] 1.01-12.5), ischemic heart disease (OR 5.02, 95% CI 1.1-9.7) and waist circumference (OR 1.06, 95% CI 1.006-1.114) were related to VFs. In the full model (adjusted for age, sex, body mass index), ischemic heart disease was the only determinant of VF (OR 3.33, CI 1.02-10.91, P = 0.047); whereas diabetic retinopathy did not reached significance (OR 2.27, CI 0.71-7.27, P = 0.16). CONCLUSIONS: In summary, ischemic heart disease is associated with an increased risk of VFs in type 2 diabetes mellitus.