Table 3 Sexual dimorphism in major risk factors and biochemical markers for risk assessment and stratification in screening for osteoporosis
From: Insights and implications of sexual dimorphism in osteoporosis
Risk factors/Biochemical markers | Women | Men |
|---|---|---|
Unchangeable risk factors | ||
Older age, family history of osteoporosis, family history of fractures, previous fracture, small bone frame size, white or Asian ethnicity | ✔ | ✔ |
Alterations in major sex hormone levels | ||
A decline in estrogen at menopause Reduction in testosterone levels with aging | ✔ ✖ | ✖ ✔ |
Lifestyle-related risk factors | ||
Sedentary lifestyle or lack of physical activity, excessive alcohol consumption, cigarette smoking | ✔ | ✔ |
Dietary risk factors | ||
Inadequate calcium intake, Insufficient nutrients | ✔ | ✔ |
Long-term use of some medications | ||
Glucocorticoids Medications to reduce estrogen levels for breast cancer treatment Androgen deprivation therapy for the treatment of prostate cancer Thyroid hormone medication for an underactive thyroid | ✔ ✔ ✖ ✔ | ✔ ✖ ✔ ✔ |
Underlying medical conditions and diseases | ||
Diabetes mellitus, hypogonadism, thyroid disorders, hyperparathyroidism, inflammatory diseases, chronic kidney disease, chronic liver disease, cancer, eating disorders, celiac disease, VD deficiency, psychological stress | ✔ | ✔ |
Serum biochemical markers for risk assessment of osteoporosis | ||
Serum osteocalcin, BALP, PINP for bone formation, CTX-I and NTX- I for bone resorption | ✔ | ✔ |
Urinary biochemical markers for risk assessment of osteoporotic fractures | ||
The urinary ratio of native (alpha) to isomerized (beta) CTX for risk of fractures, including hip, vertebral, and nonvertebral fracture | ✔ | ✖ |
