Prevalence of osteoporosis in perimenopausal and postmenopausal women in Malwa region of Punjab

ABSTRACT

Background: Clinical sign of osteoporosis includes fragility fractures or a T-score that is <2.5 SD below the mean as determined by a dual-energy X-ray absorptiometry (DXA) scan of bone mineral density (BMD). People with T-scores of –2.5 have the highest risk of fracture. People with T-scores of –2.5 have the highest risk of fracture. However, maximum fractures are seen in patients with a T-score between –1 and –2.5 because of more people in this category. As there is very little knowledge of osteoporosis in perimenopausal and postmenopausal women in male region, this study will help us to know the current status of osteoporosis in these females. Aims and Objectives: The objective of the present study was to determine the prevalence of osteoporosis in 296 premenopausal, perimenopausal and postmenopausal women of more than 40 years of age attending midlife health clinic at a tertiary care center in Patiala, Punjab and to observe its correlation with age, menopausal status, body mass index, and dietary intake. Materials and Methods: A detailed medical, surgical, obstetrical, gynecological, and drug history were recorded in a pro forma designed for the study after taking the informed consent. Information about history of fracture on a trivial fall, family history suggestive of osteoporosis, socioeconomic status, educational status, and occupation was documented. Women having history of endocrinal disorders (hypo/hyperthyroidism, hypo/hypergonadism, and hypo/hypercalcemia), receiving therapeutic agents (thiazide diuretics, glucocorticoids, and osteoporosis treatment), having restricted mobility issues and with implants (at lumbar spine, hip, and lower limbs) were excluded from the study. Quantitative ultrasound (QUS) measurement of calcaneum was performed that T-score was generated based on the speed of sound and was used to classify the bone health status of the subjects. Results: Out of 296 women, 227 women had a low bone mass density, that is, <–1 SD. We divided all the participants into three groups as shown in Table 1. Group I (n = 69 [23.2%]) having normal BMD, that is, T score >–1 SD; Group II (n = 204 [69.2%]) included women with BMD between –1 and –2.5 SD (Osteopenia); and Group III (n = 23 [7.6%]) included women with BMD <–2.5 SD (Osteoporosis). Most women in perimenopausal (75%) and postmenopausal (64.6%) group were osteopenic (Group I). Out of all women with osteopenia (Group II, n = 204), 113 (52.1%) were postmenopausal and 82 (40.3%) were perimenopausal. All women with osteoporosis were postmenopausal. The difference between BMD categories and menopausal status was statistically significant (P = 0.014). In these women, the BMD was found to decrease with increase in the average number of years since menopause (YSM) (P = 0.06). Conclusion: Menopause is an important event in a woman’s life cycle which affects bone health with the prevalence of osteoporosis and osteopenia increasing with increasing YSM. QUS technology emerges as cost-effective screening tool for the early detection of osteoporosis for a large population in developing country like India.