Prevalence of osteoporosis in India: an observation of 31238 adults

<p><strong>Background</strong>: Aim of the study was to determine the prevalence of bone loss (both osteopenia and osteoporosis) at national and regional levels in India.</p><p><strong>Methods</strong>: In this retrospective study, data obtained from in-clinic screening camps conducted for bone loss was analysed. Participants were apparently healthy adults (aged 18 years and above) evaluated for bone mineral density (BMD) using calcaneal quantitative ultrasound (QUS) of left foot. Based on t score of BMD obtained, participants were labelled as normal (T-score &lt;-1 SD), osteopenia (t score-1 to -2.5 SD) and osteoporosis (t score &lt;-2.5 SD).</p><p><strong>Results</strong>: In total, data of 31238 participants was analysed retrospectively. Mean age was 47.8±14.2 years and 47.6% were females. Among females, 38.8% were postmenopausal women (age &gt;50 years). Overall prevalence of osteopenia and osteoporosis was 49.9 and 18.3% respectively. Across East, West, North and South India, the prevalence of osteopenia was 51.3, 47.9, 55.6 and 47.4% respectively whereas prevalence of osteoporosis was 18.4, 16.3, 16.4 and 20.7% respectively. Prevalence of osteoporosis was slightly higher in females than males (19.4 vs 17.3%). Among postmenopausal women, overall osteoporosis prevalence was 33.1% and ranged from 16.9% in North region to 21.8% South region. Prevalence of osteoporosis (37.0 vs 12.5%) was higher in elderly (≥60 years) than adults (&lt;60 years).</p><p><strong>Conclusions</strong>: Among adults, nearly one out of two have osteopenia and one out of five have osteoporosis. Osteoporosis prevalence was higher in the women and in the elderly. Nearly one out of three women in postmenopausal age group have osteoporosis. There is no substantial difference across the four regions of the country. Considering the significant prevalence of low BMD, there is need to increase the awareness about bone health in general population.</p><p> </p><p> </p>

Associations between Bone Material Strength Index, Calcaneal Quantitative Ultrasound and Bone Mineral Density in Men

Objectives Impact microindentation (IMI) measures bone material strength index (BMSi) in vivo. This study investigated how IMI is associated with calcaneal quantitative ultrasound and bone densitometry parameters in men. Methods BMSi was measured on the tibial plateau using the OsteoProbe in 377 men (ages 33-96yr) from the Geelong Osteoporosis Study. Broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness index (SI) were assessed at the calcaneus using an ultrasonometer. Areal BMD was measured at several skeletal sites using dual-energy X-ray absorptiometry. Linear associations between parameters were tested using Pearson’s correlation. Multivariable regression techniques were used to determine associations between BMSi and other measures of bone, independent of confounders. Results BMSi was negatively correlated with age (r = -0.171, p=0.001), weight (r = -0.100, p=0.052) and body mass index (r = -0.187, p=0.001), and positively with height (r = +0.109, p=0.034). There was some evidence to support a positive association between BMSi and BUA (β=0.052, p=0.037), SOS (β=0.013, p=0.144) and SI (β=0.036, p=0.051). After age adjustment, this association was attenuated. No correlations were observed between BMSi and BMD at any skeletal site (r-values ranged from -0.006 to +0.079, all p&gt;0.13). Conclusion There was a small positive association between BMSi and QUS parameters, which were not independent of age. No associations were detected between BMSi and BMD. This suggests that BMSi and QUS are capturing common age-dependent properties of bone. Further research on the utility of IMI alone and complementary to conventional bone testing methods for predicting fracture risk is warranted.

Calcaneal Bone Quality and Physique in Elite Hungarian Male Athletes.

Regular physical activity has favourable influence on the bone status. The purpose of this study was to analyze the relationships between the bone quality index (BQI) in the calcaneus and anthropometric variables in male elite athletes. Participants were Hungarian elite male athletes: kayak-canoe (KC, n=43); triathlon (T, n=16); track & field (TF, n=46); water-polo (WP, n=19). Their physique was characterised by Heath-Carter somatotype. Calcaneal Quantitative Ultrasound (QUS) parameters were registered by Sonost3000 densitometer. Differences in bone quality between the groups and correlation patterns between QUS and physique were analysed (p<0.05). There were significant differences in QUS parameters. T and TF had significantly higher SOS (speed of sound, m/s) values than WP. KC had lower SOS values than T athletes (TF: 1519.3±16.0; T: 1512.9±20.8; KC: 1505.6±12.4; W: 1495.1±10.8. BUA (broadband ultrasound attenuation, dB/MHz) was the largestest in TF but this only differed significantly from WP (TF: 106.5±14.8; T: 98.9±11.5; KC: 98.7±16.5; WP: 92.2±8.8). BQI (αSOS+βBUA) was higher in TF (92.0±16.7) than in KC (79.2±13.1), WP (69.3±10.0); it was higher in T (84.8±19.6) than WP. Muscle percentage correlated positively, while absolute bone measurements correlated inversely with bone parameters. Higher QUS values were associated with lower endomorphy and mesomorphy, while more linear physiques correlated with better bone parameters. Physique and type of exercise training appear to be associated with bone status. Both weight-bearing and non-weight bearing exercise improve calcaneus bone parameters such as BQI to different extents. It might be preferable to combine some weight-bearing exercise during the sessions, and it is also highly recommended after a competitive period and during recreational sport activities.

Aktivitas berjalan meningkatkan bone mineral density pada perempuan pascamenopause

LATAR BELAKANGOsteoporosis merupakan penyakit tulang yang ditandai dengan rendahnya bone mineral density (BMD) disertai perubahan pada mikroarsitektur tulang. BMD yang rendah menandai adanya penurunan kepadatan pada tulang dan meningkatkan risiko terjadinya fraktur. Penurunan kadar estrogen pada kondisi pascamenopause, gaya hidup yang meliputi aktivitas fisik dan kebiasaan berjalan sangat berperanan dalam progresivitas osteoporosis. Penelitian ini bertujuan menilai hubungan antara aktivitas berjalan dengan kepadatan tulang pada perempuan pascamenopause. METODEPenelitian analitik observasional dengan metode cross-sectional dilakukan pada perempuan pascamenopause berusia 45-70 tahun pada periode Agustus-Oktober 2018. Penilaian aktivitas berjalan dilakukan dengan menggunakan kuesioner dan wawancara. Aktivitas berjalan dinilai dari jumlah langkah berjalan/hari yang dikonversikan dari jarak tempuh subjek berjalan kaki setiap harinya. Pengukuran BMD menggunakan calcaneal quantitative ultrasound (QUS), hasil pengukuran BMD membedakan kepadatan tulang berdasarkan nilai-T. Analisis data dilakukan dengan uji statistik Chi Square dengan tingkat kemaknaan p<0.05. HASILSebanyak 88 perempuan pascamenopause ikut berpartisipasi sebagai subjek penelitian dengan usia (rerata ± simpang baku) 57.91 ± 7.25 tahun. Distribusi aktivitas berjalan didapatkan 71 (80.7%) kurang aktif, 12 (13.6%) aktivitas sedang, dan 5 (5.7%) aktif. Distribusi hasil penilaian kepadatan tulang didapatkan sebanyak 18 (20.5%) normal, 49 (55.75%) osteopenia dan 21 (23.9%) osteoporosis. Hasil analisis statistik menunjukkan terdapat hubungan yang bermakna antara aktivitas berjalan dan kepadatan tulang pada perempuan pascamenopause (p=0.009). KESIMPULANTerdapat hubungan yang bermakna antara aktivitas berjalan dan kepadatan tulang pada perempuan pascamenopause.

Asupan kafein dari kopi dan teh serta hubungannya dengan kepadatan tulang pada perempuan pascamenopause

LATAR BELAKANGOsteoporosis merupakan kondisi patologis tulang dengan karakteristik bone mineral density (BMD) yang rendah disertai perubahan mikro-arsitektur jaringan tulang, sehingga meningkatkan risiko fraktur. Faktor risiko osteoporosis yaitu perempuan pascamenopause, genetik, indeks massa tubuh, aktivitas fisik, asupan gizi dan mineral, merokok, serta asupan alkohol, dan kafein. Penelitian ini bertujuan untuk menilai efek kafein dari kopi dan teh terhadap kepadatan tulang pada perempuan pascamenoapuse. METODEPenelitian ini merupakan penelitian analitik observasional dengan desain cross-sectional. Subjek penelitian adalah perempuan pascamenopause yang berusia >40 tahun berjumlah 92 orang. Asupan kafein dinilai dari total asupan yang berasal dari kopi dan teh dengan menggunakan kuesioner dan wawancara. Perhitungan asupan total kafein diperhitungkan dengan penyetaraan asupan kopi dan teh per minggu. Kepadatan tulang dinilai menggunakan alat calcaneal quantitative ultrasound untuk menetukan nilai-T sebagai parameter osteoporosis. Subjek dikelompokkan sebagai kepadatan tulang normal (nilai-T≥-1), osteopenia (nilai-T antara -1 sampai -2.5) dan osteoporosis (nilai-T<-2.5) Analisis statistik dilakukan untuk menilai hubungan kedua variabel dilakukan dengan uji Chi-square. HASILRerata (simpang baku) usia subjek adalah 57.84 ± 7.57. Sebanyak 26 (28.3%) subjek dengan kategori osteoporosis, 50 (54.3%) osteopenia, dan 16 (17.4%) normal. Asupan kafein didapatkan 69 subjek (75%) dengan kategori rendah dan 23 (25%) tinggi. Hasil analisis didapatkan tidak terdapat hubungan yang bermakna antara asupan kafein dan kepadatan tulang (p=0.419; p>0.05). KESIMPULANTidak terdapat hubungan antara asupan kafein dari kopi dan teh dengan kepadatan tulang pada perempuan pascamenopause.

The Performance of a Calcaneal Quantitative Ultrasound Device, CM-200, in Stratifying Osteoporosis Risk among Malaysian Population Aged 40 Years and Above

Background: Calcaneal quantitative ultrasound (QUS) is widely used in osteoporosis screening, but the cut-off values for risk stratification remain unclear. This study validates the performance of a calcaneal QUS device (CM-200) using dual-energy X-ray absorptiometry (DXA) as the reference and establishes a new set of cut-off values for CM-200 in identifying subjects with osteoporosis. Methods: The bone health status of Malaysians aged ≥40 years was assessed using CM-200 and DXA. Sensitivity, specificity, area under the curve (AUC) and the optimal cut-off values for risk stratification of CM-200 were determined using receiver operating characteristic (ROC) curves and Youden’s index (J). Results: From the data of 786 subjects, CM-200 (QUS T-score <−1) showed a sensitivity of 82.1% (95% CI: 77.9–85.7%), specificity of 51.5% (95% CI: 46.5–56.6%) and AUC of 0.668 (95% CI: 0.630–0.706) in identifying subjects with suboptimal bone health (DXA T-score <−1) (p < 0.001). At QUS T-score ≤−2.5, CM-200 was ineffective in identifying subjects with osteoporosis (DXA T-score ≤−2.5) (sensitivity 14.4% (95% CI: 8.1–23.0%); specificity 96.1% (95% CI: 94.4–97.4%); AUC 0.553 (95% CI: 0.488–0.617); p > 0.05). Modified cut-off values for the QUS T-score improved the performance of CM-200 in identifying subjects with osteopenia (sensitivity 67.7% (95% CI: 62.8–72.3%); specificity 72.8% (95% CI: 68.1–77.2%); J = 0.405; AUC 0.702 (95% CI: 0.666–0.739); p < 0.001) and osteoporosis (sensitivity 79.4% (95% CI: 70.0–86.9%); specificity 61.8% (95% CI: 58.1–65.5%); J = 0.412; AUC 0.706 (95% CI: 0.654–0.758); p < 0.001). Conclusion: The modified cut-off values significantly improved the performance of CM-200 in identifying individuals with osteoporosis. Since these values are device-specific, optimization is necessary for accurate detection of individuals at risk for osteoporosis using QUS.