Abstract
Summary
The prevention, education, and treatment of osteoporosis are all recognized as important components in men as well as women. This study revealed that the lifestyle factors associated with male osteoporosis included being underweight and being a current smoker. Being overweight or obese and having a regular exercise habit were negatively associated with male osteoporosis.
Purpose
Osteoporosis is a significant health problem in Korea and worldwide. Although osteoporosis is less prevalent in males than in females, the fracture-related mortality rate is higher in males than in females. The aim of this study was to investigate the relationship of modifiable lifestyle factors in males with osteoporosis.
Methods
A case-control study was performed in men who visited a single university hospital for a medical check-up between August 2003 and July 2016. Patients were classified in the case group according to the World Health Organization (WHO) Osteoporosis Criteria. The control group was created by matching patients according to age and check-up date. Lifestyle factors were evaluated by a self-assessment questionnaire. Multivariate conditional logistic regression was used to examine the association between lifestyle factors and male osteoporosis with age stratification at 50 years.
Results
A total of 1304 subjects were included in this analysis, 326 of whom were in the case group and 978 of whom were in the control group. Within their age group, subjects with osteoporosis were more often underweight (odds ratio [OR] = 2.35, 95% confidence interval [CI], 1.11–4.98) or more often current smokers (2.22, 1.50–3.28) than control subjects. The subjects who were overweight (0.45, 0.32–0.64), obese (0.19, 0.13–0.27), had an irregular exercise habit (0.64, 0.43–0.94), or had a regular exercise habit (0.40, 0.28–0.57) were more likely to have normal bone status. Alcohol drinking habit had no significant association with male osteoporosis.
Conclusions
Several modifiable lifestyle factors were associated with male osteoporosis. Current smokers at any age and underweight men below age 50 were more likely to have osteoporosis, whereas men who were overweight, obese, or had a regular exercise habit were more likely to have normal bone status, regardless of age.
References
Wagner KH, Brath H (2012) A global view on the development of non communicable diseases. Prev Med 54(Suppl):S38–S41
Consensus A (1991) Consensus development conference: prophylaxis and treatment of osteoporosis. Am J Med 90(1):107–110
Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9(8):1137–1141
Gabriel SE, Tosteson AN, Leibson CL, Crowson CS, Pond GR, Hammond CS et al (2002) Direct medical costs attributable to osteoporotic fractures. Osteoporos Int 13(4):323–330
Cauley JA (2015) Estrogen and bone health in men and women. Steroids 99:11–15
Jones G, Nguyen T, Sambrook P, Kelly P, Eisman J (1994) Progressive loss of bone in the femoral neck in elderly people: longitudinal findings from the Dubbo osteoporosis epidemiology study. BMJ 309(6956):691–695
Looker AC, Orwoll ES, Johnston CC Jr, Lindsay RL, Wahner HW, Dunn WL et al (1997) Prevalence of low femoral bone density in older US adults from NHANES III. J Bone Miner Res 12(11):1761–1768
Willson T, Nelson SD, Newbold J, Nelson RE, LaFleur J (2015) The clinical epidemiology of male osteoporosis: a review of the recent literature. Clin Epidemiol 7:65–76
Rhee EJ, Oh KW, Lee WY, Kim SW, Oh ES, Baek KH et al (2004) Age, body mass index, current smoking history, and serum insulin-like growth factor-I levels associated with bone mineral density in middle-aged Korean men. J Bone Miner Metab 22(4):392–398
Hyeon JH, Gwak JS, Hong SW, Kwon H, Oh SW, Lee CM (2016) Relationship between bone mineral density and alcohol consumption in Korean men: the Fourth Korea National Health and Nutrition Examination Survey (KNHANES), 2008–2009. Asia Pac J Clin Nutr 25(2):308–315
Yang YJ, Kim J (2014) Factors in relation to bone mineral density in Korean middle-aged and older men: 2008–2010 Korea National Health and Nutrition Examination Survey. Ann Nutr Metab 64(1):50–59
Kang YW, Ko YS, Kim KY, Sung C, Lee DH, Jeong E (2015) Trends in health-related behaviors of Korean adults: study based on data from the 2008–2014 Community Health Surveys. Epidemiol Health 37:e2015042
Bolam KA, Van Uffelen JGZ, Taaffe DR (2013) The effect of physical exercise on bone density in middle-aged and older men: a systematic review. Osteoporos Int 24(11):2749–2762
Valimaki MJ, Karkkainen M, Lamberg-Allardt C, Laitinen K, Alhava E, Heikkinen J et al (1994) Exercise, smoking, and calcium intake during adolescence and early adulthood as determinants of peak bone mass. BMJ 309(6949):230–235
Seibel MJ, Meier C, Woitge H, Witte K, Lemmer B (2004) Seasonal variation of bone turnover? J Bone Miner Res 19(1):168–169
Drake MT, Murad MH, Mauck KF, Lane MA, Undavalli C, Elraiyah T et al (2012) Clinical review. Risk factors for low bone mass-related fractures in men: a systematic review and meta-analysis. J Clin Endocrinol Metab 97(6):1861–1870
Bassett J (2000) International Diabetes Institute; World Health Organization Regional Office for the Western Pacific; International Association for the Study of Obesity; International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment. Health Communications Australia, Melbourne
Ebeling PR (2008) Clinical practice. Osteoporosis in men. New Engl J Med 358(14):1474–1482
Szulc P, Garnero P, Claustrat B, Marchand F, Duboeuf F, Delmas P (2002) Increased bone resorption in moderate smokers with low body weight: the Minos study. J Clin Endocrinol Metab 87(2):666–674
Yen CY, Tu YK, Ma CH, Yeh JH, Kao FC, Yu SW et al (2008) Measurement of tibial endothelial cell function after cigarette smoking, cessation of smoking and hyperbaric oxygen therapy. Injury 39(Suppl 4):40–46
Tamaki J, Iki M, Fujita Y, Kouda K, Yura A, Kadowaki E et al (2011) Impact of smoking on bone mineral density and bone metabolism in elderly men: the Fujiwara-kyo Osteoporosis Risk in Men (FORMEN) study. Osteoporos Int 22(1):133–141
Eleftheriou KI, Rawal JS, James LE, Payne JR, Loosemore M, Pennell DJ et al (2013) Bone structure and geometry in young men: the influence of smoking, alcohol intake and physical activity. Bone 52(1):17–26
McLernon DJ, Powell JJ, Jugdaohsingh R, Macdonald HM (2012) Do lifestyle choices explain the effect of alcohol on bonemineral density in women around menopause? Am J Clin Nutr 95:1261–1269
Lavado-Garcia J, Moran J, Lopez-Arza LG, Costa-Fernandez C, Guerrero-Bonmatty R, Lopez-Arza MG (2012) Effect of alcohol consumption on bone mineral density in healthy elderly Spanish males. Endocr Abstr 29:162
Burger H, De Laet C, Van Daele P, Weel A, Witteman J, Hofman A et al (1998) Risk factors for increased bone loss in an elderly population the rotterdam study. Am J Epidemiol 147(9):871–879
Roy DK, O'Neill TW, Finn JD, Lunt M, Silman AJ, Felsenberg D et al (2003) Determinants of incident vertebral fracture in men and women: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 14(1):19–26
Al-Ani AN, Neander G, Samuelsson B, Blomfeldt R, Ekstrom W, Hedstrom M (2013) Risk factors for osteoporosis are common in young and middle-aged patients with femoral neck fractures regardless of trauma mechanism. Acta Orthop 84(1):54–59
Oldroyd A, Mitchell K, Bukhari M (2014) The prevalence of osteoporosis in an older population with very high body mass index: evidence for an association. Int J Clin Pract 68(6):771–774
De Laet C, Kanis JA, Oden A, Johanson H, Johnell O, Delmas P et al (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16(11):1330–1338
Pigozzi F, Rizzo M, Giombini A, Parisi A, Fagnani F, Borrione P (2009) Bone mineral density and sport: effect of physical activity. J Sports Med Phys Fitness 49(2):177–183
Langsetmo L, Hitchcock CL, Kingwell EJ, Davison KS, Berger C, Forsmo S et al (2012) Physical activity, body mass index and bone mineral density-associations in a prospective population-based cohort of women and men: the Canadian Multicentre Osteoporosis Study (CaMos). Bone 50(1):401–408
Acknowledgements
All authors (KYP, HKP, HSH) contributed to the design of the study, interpretation of the results and development of the final manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
None.
Rights and permissions
About this article
Cite this article
Park, KY., Hwang, HS. & Park, HK. Modifiable lifestyle factors associated with osteoporosis in Korean men: a case-control study. Arch Osteoporos 12, 56 (2017). https://doi.org/10.1007/s11657-017-0349-9
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s11657-017-0349-9