Free Endocrinology CME

In this online, self-learning activity:

Osteoporosis in aging men is a growing public health problem yet remains under-recognized in primary and specialty care. Population-based cohorts show that adults aged ≥80 years now account for most hip fractures, and in this age group men experience higher perioperative morbidity and mortality than women at comparable ages. Contemporary US trend analyses confirm a high and in some groups increasing prevalence of osteoporosis and low bone mass among adults ≥50 years, with substantial burden among older men. Health-economic models and actuarial reports estimate more than two million osteoporotic fractures annually in the United States, costing about $17 billion in 2005 and rising to an estimated $57 billion over the past two decades, with further growth expected by 2040; men already account for more than one-quarter of this burden. Prospective outcomes work from the ICUROS US study and Medicare claims analyses underscores prolonged quality-of-life loss and markedly higher all-cause costs after fragility fractures, especially hip and vertebral fractures in older adults, including men.

Primary care clinicians and endocrinologists play a critical role in identifying and managing metabolic dysfunction-associated steatohepatitis (MASH) before it progresses. Results from a Med-IQ survey, however, revealed that approximately half of the respondents screen only 50% or fewer of their patients with obesity or type 2 diabetes. Patients with these conditions or other risk factors, such as metabolic syndrome, dyslipidemia, or elevated liver enzymes, should be screened using noninvasive tools like FIB-4, transient elastography (FibroScan), ELF, or VCTE.

Although lifestyle modification remains the cornerstone of treatment, pharmacologic options such as GLP-1 receptor agonists, pioglitazone, and resmetirom may be appropriate based on individual risk profiles. Most patients can be effectively managed in primary care or endocrinology settings, with hepatology referral recommended for patients with a high risk of advanced fibrosis.