Men who smoke not only have a greater risk of developing osteoporosis than men who don't smoke, they have a greater risk of it than women who smoke, according to new research. Smoking and lung disease from smoking may be more significant risk factors than previously thought for osteoporosis and bone fractures in men.
Current guidelines call for screening only women for osteoporosis. These new findings may mean that the guidelines should be changed to add men who smoke, especially those who have lung problems due to smoking. Guidelines are often used to determine whether health insurance will pay for screening tests.
Osteoporosis, where bones become weak, brittle, and easy to break, it often overlooked in men. About one woman in five over age 50 has osteoporosis, but it occurs in one man in 50 over age 50. It is more common in men who have taken certain medications, notably corticosteroids such as prednisone, or who drink heavily.
Researchers at National Jewish Health, a medical center in Denver, analyzed data including bone mineral density tests and chest scans from 3,321 current and ex-smokers to determine if they had osteoporosis and serious lung diseases such as chronic obstructive pulmonary disease (COPD) and emphysema. They also collected data on bone fractures in these patients.
They found that low bone mineral density, a sign of osteoporosis, was present in 58%, but was more frequent in people with more severe worse COPD. The percentage of people with fragile bones rose to 84% of those with very severe COPD. Fractures of the spine, a symptom of osteoporosis, were present in 37% of all the people in the study. COPD and specifically emphysema were associated with both low bone mineral density and spinal fractures after the researchers accounted for steroid use, age, pack years, and current smoking.
You can read more about osteoporosis in men at http://www.niams.nih.gov/health_info/bone/osteoporosis/men.asp.
