309 KB57 KB192920262023Groti Antonič, KristinaGroti Antonič, KristinaKocjan, Tomažštevilka:11/12letnik:92str. 456-467DOI:10.6016/ZdravVestn.3435ISSN:1318-0347COBISSID:179164931URN:URN:NBN:SI:doc-G8X2BZN6slSlovensko zdravniško društvoZdravniški vestnikhipogonadizemhypogonadismosteoporosisosteoporozatestosterontestosteroneOsteoporoza pri moških – pomen hipogonadizma| Osteoporosis in men – the importance of hypogonadism|Osteoporosis is a systemic bone disease with reduced bone mineral density and disrupted bone microarchitecture, lead-ing to fractures after minimal trauma. Women are affected more often; however, men have more osteoporosis-related complications and higher mortality after fractures. Osteoporosis in men is frequently diagnosed only after a fracture. It is more often secondary, one of the most important secondary causes being hypogonadism, a condition that is also under-estimated, unrecognized, undiagnosed, and untreated. Management of osteoporosis in men is complex, with non-phar-macological and pharmacological interventions. The goal of treatment is the prevention of fractures. Testosterone re-placement therapy not only has positive effects on the skeleton, but it can also improve the quality of life of hypogonadal men. Currently, there is no direct evidence that testosterone reduces the risk of osteoporotic fractures. Before starting testosterone, all the benefits and risks should be carefully discussed with the patient. Bisphosphonates, denosumab, and teriparatide improve bone mineral density and decrease vertebral fracture risk. They are also effective in men with osteo-porosis and hypogonadismOsteoporoza je sistemska bolezen kosti z znižano mineralno kostno gostoto in spremenjeno mikroarhitekturo kostnine, kar vodi do zlomov ob majhni poškodbi. Čeprav pogosteje prizadene ženske, imajo moški zaradi osteoporoze več zapletov in višjo umrljivost po zlomih. Pri moških diagnozo osteoporoze večkrat postavimo šele po zlomu. Pogosteje je sekundarna, med najpomembnejšimi sekundarnimi vzroki je hipogonadizem, ki je prav tako podcenjeno, premalo prepoznano ter pre-redko diagnosticirano in zdravljeno stanje. Zdravljenje osteoporoze pri moških je kompleksno, vključuje nefarmakološke in farmakološke ukrepe. Cilj zdravljenja je preprečevanje zlomov. Nadomestno zdravljenje s testosteronom poleg pozitiv-nih učinkov na skelet pri hipogonadnih moških izboljša tudi kakovost življenja. Neposrednih dokazov, da bi zdravljenje s testosteronom zmanjšalo tveganje za osteoporozne zlome, zaenkrat ni. Pred uvedbo testosterona skupaj z bolnikom skrb-no pretehtamo koristi in tveganja. Bisfosfonati, denosumab in teriparatid izboljšajo mineralno kostno gostoto in zmanjša-jo tveganje za zlome vretenc. Učinkoviti so tudi pri moških z osteoporozo in s hipogonadizmomTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo