Risk Factors for Osteoporosis in Postmenopausal Women: A Cross-Sectional Analysis
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Background: Osteoporosis represents a significant public health concern, particularly among postmenopausal women. While established risk factors exist, the relative contribution and interaction of these factors in different populations remain incompletely understood.
Objective: This study aimed to identify and quantify the prevalence and relative impact of modifiable and non-modifiable risk factors for osteoporosis in a diverse cohort of postmenopausal women.
Methods: A cross-sectional study was conducted among 742 postmenopausal women aged 50-80 years. Bone mineral density (BMD) was measured using dual-energy X-ray absorptiometry (DXA). Data on demographic characteristics, lifestyle factors, medical history, and biochemical parameters were collected. Multiple logistic regression analyses were performed to identify independent risk factors associated with osteoporosis.
Results: The prevalence of osteoporosis in the study population was 32.6%. Significant independent risk factors included age (OR=1.08 per year, 95% CI: 1.05-1.11), low body mass index (OR=2.64 for BMI <22 kg/m², 95% CI: 1.87-3.72), early menopause (OR=1.92, 95% CI: 1.34-2.76), family history of osteoporosis (OR=2.17, 95% CI: 1.53-3.08), smoking (OR=1.76, 95% CI: 1.21-2.56), low calcium intake (OR=1.89, 95% CI: 1.38-2.59), and physical inactivity (OR=2.09, 95% CI: 1.51-2.89). Vitamin D deficiency, alcohol consumption, and prolonged corticosteroid use were also significantly associated with increased osteoporosis risk.
Conclusion: Numerous modifiable and non-modifiable risk factors for osteoporosis in postmenopausal women were discovered in this study; the highest correlations were seen for early menopause, low BMI, physical inactivity, and family history. According to our research, risk assessment instruments that take these variables into account might improve the early detection of high-risk patients and enable focused preventative measures.
Black DM, Rosen CJ. Clinical Practice. Postmenopausal Osteoporosis. N Engl J Med. 2016;374(3):254-62.
Kanis JA, Cooper C, Rizzoli R, Reginster JY; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis (ESCEO) and the Committees of Scientific Advisors and National Societies of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int. 2019;30(1):3-44.
Compston JE, McClung MR, Leslie WD. Osteoporosis. Lancet. 2019;393(10169):364-76.
Curtis EM, Moon RJ, Harvey NC, Cooper C. The impact of fragility fracture and approaches to osteoporosis risk assessment worldwide. Bone. 2017;104:29-38.
Eastell R, O'Neill TW, Hofbauer LC, Langdahl B, Reid IR, Gold DT, et al. Postmenopausal osteoporosis. Nat Rev Dis Primers. 2016;2:16069.
Cauley JA. Estrogen and bone health in men and women. Steroids. 2015;99(Pt A):11-5.
Khosla S, Hofbauer LC. Osteoporosis treatment: recent developments and ongoing challenges. Lancet Diabetes Endocrinol. 2017;5(11):898-907.
Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden. Arch Osteoporos. 2013;8:136.
Schuit SC, van der Klift M, Weel AE, de Laet CE, Burger H, Seeman E, et al. Fracture incidence and association with bone mineral density in elderly men and women: the Rotterdam Study. Bone. 2004;34(1):195-202.
Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int. 2008;19(4):385-97.
Kanis JA, Harvey NC, Johansson H, Odén A, Leslie WD, McCloskey EV. FRAX Update. J Clin Densitom. 2017;20(3):360-7.
Ensrud KE, Crandall CJ. Osteoporosis. Ann Intern Med. 2017;167(3).
Weaver CM, Alexander DD, Boushey CJ, Dawson-Hughes B, Lappe JM, LeBoff MS, et al. Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int. 2016;27(1):367-76.
Kerschan-Schindl K. Prevention and rehabilitation of osteoporosis. Wien Med Wochenschr. 2016;166(1-2):22-7.
Kanis JA, Johansson H, Odén A, McCloskey EV. The distribution of FRAX®-based probabilities in women from Japan. J Bone Miner Metab. 2012;30(6):700-5.
Marques A, Ferreira RJ, Santos E, Loza E, Carmona L, da Silva JA. The accuracy of osteoporotic fracture risk prediction tools: a systematic review and meta-analysis. Ann Rheum Dis. 2015;74(11):1958-67.
Crandall CJ, Newberry SJ, Diamant A, Lim YW, Gellad WF, Booth MJ, et al. Comparative effectiveness of pharmacologic treatments to prevent fractures: an updated systematic review. Ann Intern Med. 2014;161(10):711-23.
Rizzoli R, Biver E, Bonjour JP, Coxam V, Goltzman D, Kanis JA, et al. Benefits and safety of dietary protein for bone health-an expert consensus paper endorsed by the European Society for Clinical and Economical Aspects of Osteopororosis, Osteoarthritis, and Musculoskeletal Diseases and by the International Osteoporosis Foundation. Osteoporos Int. 2018;29(9):1933-48.
Ralston SH, Uitterlinden AG. Genetics of osteoporosis. Endocr Rev. 2010;31(5):629-62.
Russell RG. Bisphosphonates: the first 40 years. Bone. 2011;49(1):2-19.
Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025. J Bone Miner Res. 2007;22(3):465-75.
Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17(12):1726-33.
Khosla S, Shane E. A crisis in the treatment of osteoporosis. J Bone Miner Res. 2016;31(8):1485-7.
Rosen CJ, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, et al. IOM committee members respond to Endocrine Society vitamin D guideline. J Clin Endocrinol Metab. 2012;97(4):1146-52.
Bliuc D, Nguyen ND, Alarkawi D, Nguyen TV, Eisman JA, Center JR. Accelerated bone loss and increased post-fracture mortality in elderly women and men. Osteoporos Int. 2015;26(4):1331-9.
Nguyen TV, Center JR, Eisman JA. Osteoporosis: underrated, underdiagnosed and undertreated. Med J Aust. 2004;180(5 Suppl).
Watts NB, Bilezikian JP, Camacho PM, Greenspan SL, Harris ST, Hodgson SF, et al. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the diagnosis and treatment of postmenopausal osteoporosis. Endocr Pract. 2010;16 Suppl 3:1-37.
Pothiwala P, Evans EM, Chapman-Novakofski KM. Ethnic variation in risk for osteoporosis among women: a review of biological and behavioral factors. J Womens Health (Larchmt). 2006;15(6):709-19.
Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, et al. Clinician's Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int. 2014;25(10):2359-81.
Briot K, Roux C, Thomas T, Blain H, Buchon D, Chapurlat R, et al. 2018 update of French recommendations on the management of postmenopausal osteoporosis. Joint Bone Spine. 2018;85(5):519-30.

