Factors associated with osteopenia and osteoporosis in women undergoing bone
          mineral density test

Silva, Ana Carolina Veiga; Rosa, Maria Inês da; Fernandes, Bruna; Lumertz, Suéli; Diniz, Rafaela Maria; Damiani, Maria Eduarda Fernandes dos Reis

doi:10.1016/j.rbr.2014.08.012

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Original articles • Rev. Bras. Reumatol. 55 (3) • May-Jun 2015 • https://doi.org/10.1016/j.rbr.2014.08.012 copy

Factors associated with osteopenia and osteoporosis in women undergoing bone mineral density test^☆ ☆ Institution: Universidade do Extremo Sul Catarinense – UNESC, Laboratory of Epidemiology.

Authorship SCIMAGO INSTITUTIONS RANKINGS

The aim of this study was to determine the prevalence of osteopenia and osteoporosis in a female population, that had bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) in a specialized clinic in the south of Brazil. We conducted a cross-sectional study including 1871 women that performed scans between January and December 2012. We conducted a logistic regression analysis with all independent variables and outcomes (osteopenia, osteoporosis and fracture risk). According to DXA results, 36.5% of women had normal BMD, 49.8% were diagnosed with osteopenia and 13.7% with osteoporosis. Menopause and age over 50 years old were risk factors for osteopenia and osteoporosis while prior hysterectomy and BMI greater than 25 were protective factors. For the outcome of fracture at any site the risk factors were age over 50 years old, osteopenia and osteoporosis (OR = 2.09, 95% CI: 1.28–3.40) and (OR = 2.49, 95% CI: 1.65–3.74), respectively.

Osteoporosis; Dual-energy X-ray absorptiometry; Epidemiology; Metabolic bone diseases

Variable	Average ± SD or n (%)
Age (years old)	59.2 ± 10.5
Weight (kg)	68.7 ± 12.8
Height (m)	1.57 ± 0.06
Femoral neck BMD	0.89 ± 0.27 t score: −1.03
Total femoral BMD	0.93 ± 0.15 t score: −0.59
Lumbar spine BMD	1.0 ± 0.17 t score: −0.75

BMI (kg/m²)	27.7 ± 5.0
≥24.9 kg/m²	592 (34.9)
≥25 kg/m²	1104 (65.1)

Fractures (n = 104)
Forearm	45 (43.3)
Ribs	24 (23.0)
Femur	22 (21.2)
Spine	13 (12.5)

Calcium intake
Yes	595 (31.9)
No	1273 (68.1)

DXA diagnosis
Normal	682 (36.5)
Osteopenia	932 (49.8)
Osteoporosis	257 (13.7)

Use of thyroid medication
Yes	412 (22.1)
No	1455 (77.9)

Hysterectomy
Yes	461 (24.9)
No	1392 (75.1)

Oophorectomy
Yes	332 (18.1)
No	1506 (81.9)

Variable	BMD
	Normal	Osteopenia	Osteoporosis	p -Value^a a p -Value, chi-square test; BMD, bone mineral density; BMI, body mass index; HRT, hormone replacement therapy.
	n (%)	n (%)	n (%)	Osteopenia vs. normal	Osteoporosis vs. normal
Total	682 (36.5)	932 (49.8)	357 (13.7)

Age		16.4 (10)	19.7 (12)	<0.001	<0.001
Up to 51	264 (55.9)	193 (40.8)	16 (3.3)
52–57	196 (42.6)	213 (46.3)	51 (11.1)
58–65	143 (30.4)	256 (54.4)	71 (15.2)
66 or older	79 (16.9)	270 (57.7)	119 (25.4)

BMI				<0.001	<0.001
Up to 24.9	164 (27.7)	304 (51.4)	124 (20.9)
25–29.9	219 (38.8)	277 (49.2)	68 (12.0)
30–34.9	166 (45.1)	172 (46.7)	30 (8.2)
35–39.9	45 (40.2)	54 (48.2)	13 (11.6)
40 or more	18 (41.9)	20 (46.5)	5 (11.6)

Menopause				<0.001	<0.001
Yes	481 (71.0)	797 (86.2)	235 (92.5)
No	196 (29)	128 (13.8)	19 (7.5)

HRT
Yes	105 (15.8)	147 (16.3)	35 (13.8)	0.770	0.470
No	561 (84.2)	754 (83.7)	218 (86.2)

Fractures				0.002	<0.001
Yes	22 (3.2)	63 (6.8)	34 (13.3)
No	659 (96.8)	865 (93.2)	222 (86.7)

Variable	Adjusted OR (CI 95%)
	Osteopenia	Osteoporosis
Age
50 years or older	2.80 (2.20–3.57)	6.34 (4.36–9.23)
Up to 49 years old	1.00	1.00

BMI
25 or more	0.46 (0.36–0.59)	0.22 (0.15–0.32)
Up to 24.9	1.00	1.00

Hysterectomy
Yes	0.67 (0.52–0.87)	0.61 (0.41–0.92)
No	1.00	1.00

Menopause
Yes	2.17 (1.63–2.88)	3.33 (1.92–5.77)
No	1.00	1.00

Variable	Adjusted OR (CI 95%)
Age
50 years or older	2.09 (1.28–3.40)
Up to 49 years old	1.00

BMD
Osteopenia/osteoporosis	2.49 (1.65–3.74)
Normal	1.00

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[1] *Corresponding author. E-mail: mir@unesc.net (M.I. da Rosa).

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Factors associated with osteopenia and osteoporosis in women undergoing bone mineral density test☆ ☆ Institution: Universidade do Extremo Sul Catarinense – UNESC, Laboratory of Epidemiology.

Factors associated with osteopenia and osteoporosis in women undergoing bone mineral density test^☆ ☆ Institution: Universidade do Extremo Sul Catarinense – UNESC, Laboratory of Epidemiology.