Quality Indicators for Management of Osteoporosis
Authors: Douglas C. Bauer, Eric Orwoll
Journal: Annals of Internal Medicine (2002)

Letters1 October 2002Quality Indicators for Management of OsteoporosisDouglas C. Bauer, MD and Eric Orwoll, MDDouglas C. Bauer, MDUniversity of California, San Francisco; San Francisco, CA 94143 (Bauer)Oregon Health & Science University; Portland, OR 97201-3098 (Orwoll)Search for more papers by this author and Eric Orwoll, MDUniversity of California, San Francisco; San Francisco, CA 94143 (Bauer)Oregon Health & Science University; Portland, OR 97201-3098 (Orwoll)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-7-200210010-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We disagree strongly with Quality Indicator 9 in the article by Grossman and MacLean on management of osteoporosis in vulnerable elders (1). This indicator states that male vulnerable elders who have osteoporosis and are hypogonadal should be offered testosterone treatment because it “has been shown to improve bone density and therefore may decrease fracture risk” (1). Hypogonadal men are defined as those with low testosterone levels. This conclusion infers that low testosterone levels in men are causally related to osteoporosis, that testosterone treatment is safe and effective, and that other available treatments are less effective or unsafe. ...References1. Grossman JM, MacLean CH. Quality indicators for the management of osteoporosis in vulnerable elders. Ann Intern Med. 2001;135:722-30. [PMID: 11601955] LinkGoogle Scholar2. Amin S, Zhang Y, Sawin CT, Evans SR, Hannan MT, Kiel DP, et al . Association of hypogonadism and estradiol levels with bone mineral density in elderly men from the Framingham study. Ann Intern Med. 2000;133:951-63. [PMID: 11119396] LinkGoogle Scholar3. Khosla S, Melton LJ, Atkinson EJ, O'Fallon WM. Relationship of serum sex steroid levels to longitudinal changes in bone density in young versus elderly men. J Clin Endocrinol Metab. 2001;86:3555-61. [PMID: 11502778] CrossrefMedlineGoogle Scholar4. . Report of National Institute on Aging Advisory Panel on Testosterone Replacement in Men. J Clin Endocrinol Metab. 2001;86:4611-4. [PMID: 11600511] MedlineGoogle Scholar5. Orwoll E, Ettinger M, Weiss S, Miller P, Kendler D, Graham J, et al . Alendronate for the treatment of osteoporosis in men. N Engl J Med. 2000;343:604-10. [PMID: 10979796] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of California, San Francisco; San Francisco, CA 94143 (Bauer)Oregon Health & Science University; Portland, OR 97201-3098 (Orwoll) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAssociation of Hypogonadism and Estradiol Levels with Bone Mineral Density in Elderly Men from the Framingham Study Shreyasee Amin , Yuqing Zhang , Clark T. Sawin , Stephen R. Evans , Marian T. Hannan , Douglas P. Kiel , Peter W.F. Wilson , and David T. Felson Quality Indicators for the Management of Osteoporosis in Vulnerable Elders Jennifer M. Grossman and Catherine H. MacLean Quality Indicators for the Management of Osteoporosis in Vulnerable Elders Jennifer M. Grossman and Catherine H. MacLean Metrics Cited ByA perspective on male osteoporosisOsteoporosis in men 1 October 2002Volume 137, Issue 7Page: 621-622KeywordsBoneBone densityEstrogensHypogonadismOsteoporosisProstate cancerQuality indicatorsRandomized trialsSafetyTestosterone ePublished: 1 October 2002 Issue Published: 1 October 2002 CopyrightCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...