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The Effects of Race, Ethnicity, and Underlying Medical Diseases on Osteoporosis Are Still Unguided Territory for Internists
- Hau Liu, MD, MBA, MPH;
- Paul Shekelle, MD, PhD;
- Amir Qaseem, MD, PhD, MHA; and
- Eric Orwoll, MD
- From Santa Clara Valley Medical Center, San Jose, CA 95128; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073; American College of Physicians, Philadelphia, PA 19106; and Oregon Health & Science University, Portland, OR 97239.
IN RESPONSE:
We thank Drs. Bohinc and Snyder for their insightful comments regarding our recent systematic review and guideline on screening for osteoporosis in men. We concur that a deeper evaluation of race and ethnicity in male osteoporosis, as has been performed in women, is much needed. Our ability to make conclusive remarks regarding the effects of race and ethnicity on screening in men is limited by the lack of research in this area. We attempted to better understand the effects of secondary causes of male osteoporosis. Our review evaluates the existing literature on key secondary causes of male osteoporosis, including alcoholism, androgen deprivation therapy or hypogonadism, and rheumatologic disease. Once again, the limited data in men makes it difficult to draw strong conclusions regarding many of these risk factors.
Ultimately, our review and guideline serve not only to synthesize the current literature on screening in male osteoporosis but also to highlight the major gaps in our understanding of this topic.
As Drs. Bohinc and Snyder point out, these gaps in the existing literature are many. As such, our papers serve not only as a review and guideline to be used by clinicians but as a call for increased research and awareness of this important yet often underdiagnosed and undertreated condition.
Paul Shekelle, MD, PhD
Veterans Affairs Greater Los Angeles Healthcare System
Los Angeles, CA 90073
Amir Qaseem, MD, PhD, MHA
American College of Physicians
Philadelphia, PA 19106
Article and Author Information
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Potential Financial Conflicts of Interest: Consultancies: H. Liu (Novartis). Grants received: H. Liu (Proctor & Gamble).
