With the aging of the population, there is a growing recognition that osteoporosis and fractures in men are a significant public health problem, and both hip and vertebral fractures are associated with increased morbidity and mortality in men. Osteoporosis in men is a heterogeneous clinical entity: whereas most men experience bone loss with aging, some men develop osteoporosis at a relatively young age, often for unexplained reasons (idiopathic osteoporosis). Declining sex steroid levels and other hormonal changes likely contribute to age-related bone loss, as do impairments in osteoblast number and/or activity. Secondary causes of osteoporosis also play a significant role in pathogenesis. Although there is ongoing controversy regarding whether osteoporosis in men should be diagnosed based on female- or male-specific reference ranges (because some evidence indicates that the risk of fracture is similar in women and men for a given level of bone mineral density), a diagnosis of osteoporosis in men is generally made based on male-specific reference ranges. Treatment consists both of nonpharmacological (lifestyle factors, calcium and vitamin D supplementation) and pharmacological (most commonly bisphosphonates or PTH) approaches, with efficacy similar to that seen in women. Increasing awareness of osteoporosis in men among physicians and the lay public is critical for the prevention of fractures in our aging male population.

中文翻译：

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男性骨质疏松症。

随着人口老龄化，人们越来越认识到男性骨质疏松症和骨折是一个重要的公共健康问题，髋部和椎骨骨折都与男性发病率和死亡率的增加有关。男性骨质疏松症是一个异质性的临床实体：虽然大多数男性随着年龄的增长而出现骨质流失，但一些男性在相对年轻的时候就会出现骨质疏松症，通常是由于无法解释的原因（特发性骨质疏松症）。性类固醇水平下降和其他荷尔蒙变化可能导致与年龄相关的骨质流失，成骨细胞数量和/或活性受损也是如此。骨质疏松症的次要原因也在发病机制中起重要作用。尽管关于是否应该根据女性或男性特定的参考范围来诊断男性骨质疏松症一直存在争议（因为一些证据表明，对于给定的骨矿物质密度水平，女性和男性的骨折风险相似），男性骨质疏松症的诊断通常基于男性特定的参考范围。治疗包括非药物（生活方式因素、钙和维生素 D 补充剂）和药物（最常见的是双膦酸盐或 PTH）方法，其疗效与女性相似。提高医生和普通公众对男性骨质疏松症的认识对于预防我们老龄化男性人口的骨折至关重要。