Étude rétrospective évaluant l’exploration étiologique de l’ostéoporose chez les hommes âgés dans un service de gériatrie français

IntroductionOsteoporosis in older men is common and causes significant mortality and morbidity. Some data suggest that conditions leading to bone fragility, including osteoporosis, are under-identified and undertreated in men. Additionally, 50% of the causes of osteoporosis are secondary in men. The latest Endocrine Society and different Rheumatology Societies Guidelines recommend additional laboratory investigations in men with osteoporosis so as to treat them more efficiently.Main goal of the studyOur aim was to determine whether men managed in our geriatrics center, diagnosed with osteoporosis, underwent investigations to determine the aetiology of osteoporosis and other bone fragility conditions and what the secondary causes were.Materials and methodWe conducted a monocentric, retrospective study including all men seen at the geriatric consult in 2016 diagnosed with osteoporosis. For each patient, we evaluated our clinical practice, whether common secondary causes were sought-after and what these aetiologies were.ResultsAmong the 121 men with a diagnosis of osteoporosis seen at the geriatric consult at the Lille University Hospital in 2016, only 51 had undergone further investigations. Among the 3 major secondary causes were identified: 17.6% glucocorticoid induced, 13.7% treatment induced hypogonadism, 11.7% late onset hypogonadism.ConclusionsA more efficient etiological assessment of osteoporosis in older men could be achieved and would improve management for our patients. This can be achieved by a better knowledge of the recommendations for etiological assessment of bone fragility and osteoporosis and a dedicated consultation within the geriatric sector. IntroductionL’ostéoporose de l’homme âgé est une pathologie fréquente, et à l’origine d’une morbi-mortalité importante. Des données suggèrent que la fragilité osseuse, et l’ostéoporose en particulier, sont sous-diagnostiquées et insuffisamment prises en charge chez l’homme, alors que, pour ce sexe, 50 % des ostéoporoses ont une cause secondaire. C’est dans ce contexte qu’en 2012, l’Endocrine Society a émis des recommandations proposant des explorations biologiques complémentaires pour les hommes ostéoporotiques afin d’améliorer la prise en charge. Les sociétés savantes de rhumatologie émettent des recommandations comparables, les plus récentes sont les recommandations françaises de 2021.Objectif principalL’objectif principal de ce travail était de déterminer si les patients ostéoporotiques pris en c