. 2025 Jul;36(7):1105-1114.

doi: 10.1007/s00198-025-07559-1. Epub 2025 Jun 4.

Asia-Pacific consensus for the management of osteoporosis in men

Chun-Feng Huang^{1

2

3}, Cheng-Jung Ho^{4

5}, Sung-Yen Lin^{4

6

7

8}, Jawl-Shan Hwang⁹, Ta-Wei Tai¹⁰, Jung-Fu Chen¹¹, Shih-Te Tu¹², Ding-Cheng Chan^{13

14

15}, Rong-Sen Yang¹⁶, Hsuan-Yu Chen¹⁶, Keh-Sung Tsai¹⁷, Tien-Tsai Cheng¹⁸, Fang-Ping Chen¹⁹, Wei-Chieh Hung^{20

21}, Yin-Fan Chang²², Der-Sheng Han^{23

24}, Manju Chandran²⁵, Ang Seng Bin^{26

27}, Joon Kiong Lee²⁸, Swan Sim Yeap²⁹, Yoon-Sok Chung^{30

31}, Kwang-Kyoun Kim³², Peter Ebeling³³, Unnop Jaisamrarn³⁴, Dipendra Pandey³⁵, Serge Ferrari³⁶, Eugene McCloskey³⁷, Natthinee Charatcharoenwitthaya³⁸, Akira Taguchi³⁹, Sarath Lekamwasam⁴⁰, Tuan Van Nguyen^{41

42}, E Michael Lewiecki⁴³, Kenneth G Saag⁴⁴, Ching-Chou Tsai⁴⁵, Fernando Marín⁴⁶, Satoshi Mori⁴⁷, Kyu Ri Hwang⁴⁸, Julie Li-Yu⁴⁹, John J Carey⁵⁰, David Kendler⁵¹, Ching Lung Cheung^{52

53}, Huei-Kai Huang⁵⁴, Vilai Kuptniratsaikul⁵⁵, Wing P Chan⁵⁶, Siew Pheng Chan⁵⁷, Lan T Ho-Pham⁵⁸, Fen Lee Hew⁵⁹, Huipeng Shi⁶⁰, Ian Reid⁶¹, John A Kanis⁶², Chung-Hwan Chen^#^{4

5

6

63

64

65

66}, Chih-Hsing Wu^#^{67

68

69}

Affiliations

¹ Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
² Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan.
³ Division of Family Medicine, En Chu Kong Hospital, New Taipei City, Taiwan.
⁴ Orthopedic Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁵ Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁶ Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁷ School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁸ Department of Orthopedics, Kaohsiung Medical University Gangshan Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁹ Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
¹⁰ Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
¹¹ Division of Metabolism and Endocrinology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
¹² Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
¹³ Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
¹⁴ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
¹⁵ Superintendent Office, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan.
¹⁶ Department of Orthopaedics, National Taiwan University Hospital, Taipei, Taiwan.
¹⁷ Superintendent Office, Far Eastern Polyclinic of Far Eastern Medical Foundation, Taipei, Taiwan.
¹⁸ Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan.
¹⁹ Keelung Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital, Keelung, Taiwan.
²⁰ Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
²¹ School of Medicine for International Students, College of Medicine, I-Shou University School, Kaohsiung, Taiwan.
²² Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
²³ Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan.
²⁴ Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan.
²⁵ Osteoporosis and Bone Metabolism Unit, Singapore General Hospital, Singapore, Singapore.
²⁶ DUKE NUS Medical School, Singapore, Singapore.
²⁷ Family Medicine Service, KK Women's and Children's Hospital, Singapore, Singapore.
²⁸ Department of Orthopedics, Beacon Hospital, Petaling Jaya, Malaysia.
²⁹ Division of Rheumatology, Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia.
³⁰ Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
³¹ Institute On Aging, Ajou University Medical Center, Suwon, Republic of Korea.
³² Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon, Republic of Korea.
³³ Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia.
³⁴ Department of Obstetrics and Gynecology, Chulalongkorn University, Bangkok, Thailand.
³⁵ Department of Orthopedics and Trauma Surgery, National Trauma Centre, National Academy of Medical Sciences, Kathmandu, Nepal.
³⁶ Service of Bone Diseases, Department of Medicine, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland.
³⁷ Division of Clinical Medicine, School of Medicine & Population Health, University of Sheffield, Sheffield, UK.
³⁸ Division of Endocrinology, Thammasat University, Bangkok, Thailand.
³⁹ Department of Oral and Maxillofacial Radiology, Matsumoto Dental University, Shiojiri, Japan.
⁴⁰ Department of Medicine, University of Ruhuna, Matara, Sri Lanka.
⁴¹ Centre for Health Technologies, University of Technology Sydney, Ultimo, Australia.
⁴² Tam Anh Research Institute, Ho Chi Minh City, Vietnam.
⁴³ New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA.
⁴⁴ University of Alabama at Birmingham, Birmingham, AL, USA.
⁴⁵ Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
⁴⁶ Department of Endocrinology, Quironsalud University Hospital, Madrid, Spain.
⁴⁷ Bone and Joint Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
⁴⁸ Department of Obstetrics & Gynecology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
⁴⁹ Department of Medicine, University of Santo Tomas Hospital, España, Manila, Philippines.
⁵⁰ Department of Medicine, University of Galway, Galway, Ireland.
⁵¹ Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
⁵² Department of Pharmacology and Pharmacy, The University of Hong Kong, Pok Fu Lam, Hong Kong, China.
⁵³ Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Pak Shek Kok, Hong Kong, China.
⁵⁴ Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
⁵⁵ Department of Rehabilitation Medicine, Mahidol University, Salaya, Thailand.
⁵⁶ Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
⁵⁷ Division of Endocrinology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁵⁸ BioMedicine Research Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
⁵⁹ Division of Endocrinology, Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia.
⁶⁰ Department of Orthopedics, National Center for Orthopedics, Shanghai 6 Th People's Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
⁶¹ Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
⁶² Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
⁶³ College of Medicine, Ph.D. Program in Biomedical Engineering, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁶⁴ Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan.
⁶⁵ Graduate Institute of Animal Vaccine Technology, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan.
⁶⁶ Graduate Institute of Materials Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung, Taiwan.
⁶⁷ Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. paulo@mail.ncku.edu.tw.
⁶⁸ Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan. paulo@mail.ncku.edu.tw.
⁶⁹ Institute of Gerontology, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City 701, Taiwan. paulo@mail.ncku.edu.tw.

^# Contributed equally.

PMID: 40464984
PMCID: PMC12209010
DOI: 10.1007/s00198-025-07559-1

Asia-Pacific consensus for the management of osteoporosis in men

Chun-Feng Huang et al. Osteoporos Int. 2025 Jul.

. 2025 Jul;36(7):1105-1114.

doi: 10.1007/s00198-025-07559-1. Epub 2025 Jun 4.

Authors

Affiliations

¹ Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
² Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan.
³ Division of Family Medicine, En Chu Kong Hospital, New Taipei City, Taiwan.
⁴ Orthopedic Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁵ Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁶ Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁷ School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁸ Department of Orthopedics, Kaohsiung Medical University Gangshan Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁹ Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
¹⁰ Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
¹¹ Division of Metabolism and Endocrinology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
¹² Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan.
¹³ Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
¹⁴ Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
¹⁵ Superintendent Office, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan.
¹⁶ Department of Orthopaedics, National Taiwan University Hospital, Taipei, Taiwan.
¹⁷ Superintendent Office, Far Eastern Polyclinic of Far Eastern Medical Foundation, Taipei, Taiwan.
¹⁸ Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, College of Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan.
¹⁹ Keelung Osteoporosis Prevention and Treatment Center, Chang Gung Memorial Hospital, Keelung, Taiwan.
²⁰ Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
²¹ School of Medicine for International Students, College of Medicine, I-Shou University School, Kaohsiung, Taiwan.
²² Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
²³ Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan.
²⁴ Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan.
²⁵ Osteoporosis and Bone Metabolism Unit, Singapore General Hospital, Singapore, Singapore.
²⁶ DUKE NUS Medical School, Singapore, Singapore.
²⁷ Family Medicine Service, KK Women's and Children's Hospital, Singapore, Singapore.
²⁸ Department of Orthopedics, Beacon Hospital, Petaling Jaya, Malaysia.
²⁹ Division of Rheumatology, Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia.
³⁰ Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
³¹ Institute On Aging, Ajou University Medical Center, Suwon, Republic of Korea.
³² Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon, Republic of Korea.
³³ Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, Australia.
³⁴ Department of Obstetrics and Gynecology, Chulalongkorn University, Bangkok, Thailand.
³⁵ Department of Orthopedics and Trauma Surgery, National Trauma Centre, National Academy of Medical Sciences, Kathmandu, Nepal.
³⁶ Service of Bone Diseases, Department of Medicine, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland.
³⁷ Division of Clinical Medicine, School of Medicine & Population Health, University of Sheffield, Sheffield, UK.
³⁸ Division of Endocrinology, Thammasat University, Bangkok, Thailand.
³⁹ Department of Oral and Maxillofacial Radiology, Matsumoto Dental University, Shiojiri, Japan.
⁴⁰ Department of Medicine, University of Ruhuna, Matara, Sri Lanka.
⁴¹ Centre for Health Technologies, University of Technology Sydney, Ultimo, Australia.
⁴² Tam Anh Research Institute, Ho Chi Minh City, Vietnam.
⁴³ New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA.
⁴⁴ University of Alabama at Birmingham, Birmingham, AL, USA.
⁴⁵ Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
⁴⁶ Department of Endocrinology, Quironsalud University Hospital, Madrid, Spain.
⁴⁷ Bone and Joint Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
⁴⁸ Department of Obstetrics & Gynecology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
⁴⁹ Department of Medicine, University of Santo Tomas Hospital, España, Manila, Philippines.
⁵⁰ Department of Medicine, University of Galway, Galway, Ireland.
⁵¹ Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
⁵² Department of Pharmacology and Pharmacy, The University of Hong Kong, Pok Fu Lam, Hong Kong, China.
⁵³ Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Pak Shek Kok, Hong Kong, China.
⁵⁴ Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
⁵⁵ Department of Rehabilitation Medicine, Mahidol University, Salaya, Thailand.
⁵⁶ Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
⁵⁷ Division of Endocrinology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
⁵⁸ BioMedicine Research Center, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
⁵⁹ Division of Endocrinology, Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia.
⁶⁰ Department of Orthopedics, National Center for Orthopedics, Shanghai 6 Th People's Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
⁶¹ Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
⁶² Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
⁶³ College of Medicine, Ph.D. Program in Biomedical Engineering, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁶⁴ Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan.
⁶⁵ Graduate Institute of Animal Vaccine Technology, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan.
⁶⁶ Graduate Institute of Materials Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung, Taiwan.
⁶⁷ Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. paulo@mail.ncku.edu.tw.
⁶⁸ Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan. paulo@mail.ncku.edu.tw.
⁶⁹ Institute of Gerontology, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan City 701, Taiwan. paulo@mail.ncku.edu.tw.

^# Contributed equally.

PMID: 40464984
PMCID: PMC12209010
DOI: 10.1007/s00198-025-07559-1

Abstract

Osteoporosis in men is an underdiagnosed and undertreated condition that leads to significant morbidity and mortality, particularly in the aging population. This consensus report provides tailored guidelines for diagnosing, preventing, and treating male osteoporosis in the Asia-Pacific region by integrating global best practices with regional adaptations.

Purpose: To establish evidence-based, region-specific guidelines for the management of male osteoporosis in the Asia-Pacific region, addressing demographic and lifestyle factors.

Methods: Expert feedback was gathered through premeeting reviews, consensus conferences, and collaborative discussions. A life-course approach was employed to align international best practices with Asia-Pacific-specific needs, emphasizing continuous monitoring and intervention from middle age onward.

Results: The 12 consensus strategies systematically approach male osteoporosis management, addressing screening, diagnosis, treatment, and long-term follow-up. Recommendations include the assessment of fracture risk for men aged 50 years and above, use of dual-energy X-ray absorptiometry (DXA) testing for men aged 70 years and above, lifestyle modifications, and pharmacological interventions such as bisphosphonates, denosumab, and anabolic agents for high-risk patients. Secondary causes of osteoporosis were highlighted, along with the establishment of fracture liaison services (FLSs) to improve long-term care. A life-course approach was proposed to optimize bone health throughout men's lives.

Conclusion: This consensus provides a comprehensive framework tailored to the Asia-Pacific region for diagnosing, preventing, and managing osteoporosis in men. By addressing region-specific challenges and promoting evidence-based interventions, the latest guidelines incorporating the consensus may depict the conceptual direction in reducing fracture risk and improving long-term bone health outcomes for osteoporosis in men.

Keywords: Asia–Pacific region; Men; consensus; fractures; osteoporosis.

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Conflict of interest statement

Declarations. Conflicts of interest: None.

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Asia-Pacific consensus for the management of osteoporosis in men

Affiliations

Asia-Pacific consensus for the management of osteoporosis in men

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