Screening of bone mineral density by densitometer and correlation with serum calcium and vitamin D levels to detect early osteoporotic changes in postmenopausal women in slum areas of Raipur and Kalupur of Ahmedabad
Keywords:Bone mass density, Dual-energy X-ray absorptiometry scan, Osteoporosis, Postmenopausal women
Background: Osteoporosis is a rising health difficulty, which is renowned in both developed and developing countries. It is linked with considerable morbidity and socio-economic burden worldwide. Various factors are responsible for osteoporosis such as race, family history, body weight, estrogen deficiency (menopause), low calcium intake, and many others. The present study was aimed to early prediction and evaluates the prevalence of osteoporosis in postmenopausal women of slum area of Ahmedabad (Raipur and Kalupur).
Methods: The prospective, single-center study included 230 postmenopausal women. Baseline demographic characteristics were recorded using standard pre-designed case record form. Eligible patients according to inclusion and exclusion criteria were underwent for dual-energy X-ray absorptiometry (DEXA) scan to measure bone mass density at the lumbar spine, femoral neck, and hip bone. Laboratory investigations such as serum calcium and serum vitamin D were performed according to standard procedure. Prediction for early detection of osteopenia and osteoporosis was evaluated based on T-score (DEXA scan).
Results: The overall prevalence of osteopenia and osteoporosis were found 28.69% and 44.34%, respectively. Prevalence of osteoporosis was found higher (50.72%) in study population belongs to age between 51 and 60 years, whereas the prevalence of osteopenia was higher (38.53%) in age group (41-50). In further, normal body mass index was associated with the higher prevalence of osteopenia and osteoporosis. The calcium deficiency, vitamin D deficiency, family history of osteoporosis were found major risk factor associated with osteopenia and osteoporosis (p<0.05). T-score was much lower at femoral neck site (−3.29±0.47) and lumbar spine site (−3.15±0.50) when compared with hip bone (−2.40±0.68).
Conclusions: The present study found moderately higher prevalence of osteopenia and osteoporosis among the postmenopausal women from slum area of Ahmedabad. Results revealed that the early measurement of bone mineral density will not only help for early detection, but it will also help for the prevention of osteoporosis.
Malhotra N, Mithal A. Osteoporosis in Indians. Indian J Med Res. 2008;127(3):263-8.
Suman VB, Perwez K, Jeganathan PS, Subbalakshmi NK, Pai SR, Shaila MD. Risk factors associated with osteoporosis - A population based study using p-Dexa technique. Int J Sci Res. 2013;3(2):1-5.
Menopause and Osteoporosis: ICMR. Available at http://www.icmr.nic.in/annual/2004-05/nirrh/8%20Chapter%204%20Menopause%20and%20Osteoporosis.pdf. Accessed 11 July 2015.
International Osteoporotic Foundation: the Asian Audit: epidemiology, costs and burden of osteoporosis in Asia, 2009. Available at http://www.iofbonehealth.org/sites/default/files/PDFs/Audit%20Asia/Asian_regional_audit_2009.pdf. Accessed 11 July 2015.
Indumati V, Patil VS, Jailkhani R. Hospital based preliminary study on osteoporosis in postmenopausal women. Indian J Clin Biochem. 2007;22(2):96-100.
Londhey V. Vitamin D deficiency: Indian scenario. J Assoc Physicians India. 2011;59:695-6.
Harinarayan CV. Prevalence of vitamin D insufficiency in postmenopausal South Indian women. Osteoporos Int. 2005;16(4):397-402.
Aggarwal N, Raveendran A, Khandelwal N, Sen RK, Thakur JS, Dhaliwal LK, et al. Prevalence and related risk factors of osteoporosis in peri- and postmenopausal Indian women. J Midlife Health. 2011;2(2):81-5.
Consensus development conference: diagnosis, prophylaxis and treatment of osteoporosis. Am J Med. 1993;94:646-50.
Cooper C, Campion G, Melton LJ 3rd. Hip fractures in the elderly: a world-wide projection. Osteoporos Int. 1992;2(6):285-9.
National Osteoporosis Foundation. America’s Bone Health: the State of Osteoporosis and Low Bone Mass in Our Nation. Washington, DC: National Osteoporosis Foundation; 2002.
Osteoporosis: what We Should Know for Self, Our Family and Patients. Available at http://www.iitk.ac.in/hc/Osteoporosis.pdf. Accessed 09 January 2015.
Garg N, Kumar A, Goel P. Prevalence of osteoporosis in a rural population of Muzaffarnagar district. JIACM. 2012;13(3):185-8.
Sharma S, Khandelwal S. Effective risk assessment tools for osteoporosis in the Indian menopausal female. J Midlife Health. 2010;1(2):79-85.
Achemlal L, Bezza A, Tazi MA. Body mass index and gynecological factors as determinants of bone mass in healthy Moroccan women Science direct. Maturitas Eur Menopause J. 2007;56(4):375-82.
Kataria S, Pareek P, Dyadic A, Kataria K, Bhati M. The effect of body mass index on bone mineral density in pre and post menopausal women of Western Rajasthan population. Int J Biol Med Res. 2012;3(3):1899-901.
Jain V, Agrawal BK, Varshney A, Biswas SS. Prediction of bone mineral density by age, body mass index and menopausal status in middle socioeconomic status women of urban Kolar region of Bhopal. IOSR J Dent and Med Sci. 2013;12(3):17-21.
Uebelhart D, Schlemmer A, Johansen JS, Gineyts E, Christiansen C, Delmas PD. Effect of menopause and hormone replacement therapy on the urinary excretion of pyridinium cross-links. J Clin Endocrinol Metab. 1991;72:367-73.
Gennari C, Agnusdei D, Nardi P, Civitelli R. Estrogen preserves a normal intestinal responsiveness to 1,25-dihydroxyvitamin D3 in oophorectomized women. J Clin Endocrinol Metab. 1990;71(5):1288-93.
Khatake PD, Jadhav SS, Afroz S. Relation between serum calcium level, bone mineral density and blood pressure in postmenopausal women. Int J Recent Trends Sci Technol. 2013;7:86-8.
Balci R, Akdeniz D, Carlioglu A, Karakurt F, Derbent A, Bayram Y. Association of bone mineral density and vitamin D levels in postmenopausal women in Ankara. New J Med. 2014;31:114-7.
Mezquita-Raya P, Munoz-Torres M, Luna JD, Luna V, Lopez-Rodriguez F, Torres-Vela E, et al. Relation between vitamin D insufficiency, bone density, and bone metabolism in healthy postmenopausal women. J Bone Miner Res. 2001;16(8):1408-15.
Malavolta N, Pratelli L, Frigato M, Mulè R, Mascia ML, Gnudi S. The relationship of vitamin D status to bone mineral density in an Italian population of postmenopausal women. Osteoporos Int. 2005;16(12):1691-7.
Robitaille J, Yoon PW, Moore CA, Liu T, Irizarry-Delacruz M, Looker AC, et al. Prevalence, family history, and prevention of reported osteoporosis in U.S. women. Am J Prev Med. 2008;35(1):47-54.
Lee WY, Oh KW, Rhee EJ, Jung CH, Kim SW, Yun EJ, et al. Relationship between subclinical thyroid dysfunction and femoral neck bone mineral density in women. Arch Med Res. 2006;37(4):511-6.
Garin MC, Arnold AM, Lee JS, Robbins J, Cappola AR. Subclinical thyroid dysfunction and hip fracture and bone mineral density in older adults: the cardiovascular health study. J Clin Endocrinol Metab. 2014;99(8):2657-64.