Journal of Reproduction & Infertility

Journal of Reproduction & Infertility

Association between demographic factors and osteoporosis in urban Iranian postmenopausal women

Authors
Afsaneh Keramat 1
Alireza Khalilifard 2
Hossein Adibi 2
Aronieh Chopra 3
Vebnaya Kunjir 3
Boshan Patwardhan 3
1 School of the Health Sciences, Pune University, Pune, India
2 Endocrinology and Metabolism Research Center (EMRC), Tehran University of Medical Sciences, Tehran, Iran
3 Center of Rheumatic Diseases, Pune, India
Abstract
Introduction: Several demographic factors may be considered as barriers to osteoporosis prevention like high rate of illiteracy and low socioeconomic status in developing countries, there is lack of studies that assess the relationship between socioeconomic status and osteoporo-sis in these countries. In this study we aimed to assess the association between demographic fac-tors and Osteoporosis in urban Iranian postmenopausal women Materials and Methods: This study was a case-control, case record and interview based study, It was conducted in two bone mineral density centers from Tehran (Bone mineral densitometry center of Shariati hospital as public and Mehrad bone densitometry as private center) during the period Jun 2002 to July 2003. Case group includes 163 Osteoporotic postmenopausal women whose their spine and femoral bone mineral density was measured by DEXA using lunar mach-ine in both centers. Controls were selected from same bone mineral density center and matched to the case patients according to age groups. SPSS (10) was used for statistical analysis. Odds Ratios were calculated to evaluate the relationship between osteoporosisi and its risk factors. Student T-test was used to compare mean values and 2 to compare frequency of variables. P-values less than 0.05 were considered significant. Results: The odds ratios with 95% confidence interval for demographic risk factors of Osteoporosis are as follow: illiteracy (no schooling) 3.4(1.64,7) in both centers, 2.31(1.06,5.06) in public center, 12.18(1.41,105.57) in private center, illiteracy of husband 5.09(1.43,18.12) in both centers, 3.76(1.04,13.69) in public center, occupation (being a housewife)1.56(.97,2.50) in both centers, 2.041(1.19,3.50) in public center, After adjustment for age, weight and height and other important factors like age of menopause, menarche and…. all of the above factors remained significant except the occupation. Other demographic factors that were assessed in this study include: patient occupation in private center, husband's occupation and marital status in both centers, none of these factors found to have significant association with osteoporosis. Conclusions: No schooling and schooling less than 6 years were the major demographic factors that were associated with Osteoporosis as risk factors in both private and public centers in Tehran. In this study we found that there was not a strong association between occupation and osteoporosis as a risk factor (especially in private center, among rather high socioeconomic group). High education level has been shown as a protective factor of osteoporosis in both centers.
Keywords
Demographic factors
menopause
Osteoporosis
risk factor
Woolf A.D. Strong bones in later life. Bulliten of the World Health Organization the interna-tional Journal of Public health.1999;77:368-369.
Wark J.D. Osteoporosis: a global perspective. Bulliten of the World Health Organization the international journal of public Health.1999;77: 451-458.
Eastell R., Reid D.M., Compston J., Cooper C., Fogelman I., Francis R.M., Hay S.M., Hosking D. J., Purdie D.W., Ralston S.H., Reeve J., Russell R.G., Stevenson J.C. Secondary prevention of ost-eoporosis: when should a non-vertebral fracture be a trigger for action?. QJM.2001;94: 575-97.
DeCastro J.A.S. The view from Brazil: desi-rable but not yet feasible. Bulliten of the Word Health Organization The International Journal Of the Public Health.1999;77:424-426.
Delmas P.D., Fraser M. Strong bones In Later life: Luxury or necessity?. Bulletin of the Word Health Organization The International Journal Of Public Health.1899; 77:416-422.
Poor G. Osteoporosis care in Hungary. Bulletin of the World Health Organization The Interna-tional journal of Public Health. Bull World Health Organ.1999;77(5):429-30.
Ettinger B. Personal perspective on low-dosage estrogen therapy for postmenopausal women. Menopause.1999;6:273-6.
Berarducci A. Osteoporosis awareness.Fla nur-se.1998;46:1-2(Review).
Decastro J.A.S., Osteoporosis in brazil. Bull World Health Organ.2002;pp:80-89.
Ghosh U.K., Roy S., Sharma D., Gaur S.C., Ganguli G. Relationship of osteoporosis with socioeconomic status, physical activity and puerp- eral calcium supplementation. J Obstet Gynecol India.1996;46:224-8.
Schriger D.L. Analyzing the relationship of exercise and health: methods, assumptions, and limitations. Med Sci Sports Exer.2001;33(6 Suppl):S359-63.
Hardy R., Kuh D. Social and environmental conditions across the life course and age at meno-pause in a British birth cohort study. BJOG.2005; 112:346-54.
Greendale G.A., Huang M.H., Wang Y., Fink-elstein J.S., Danielson M.E. Sport and home phys-ical activity are independently associated with bone density.Med Sci Sports Exer.2003;35:506-12.
Varenna M., Binelli L., zucchi F., Ghiringhlli D., Gallazzi M., Sinigaglia S. Prevalence of Oste-oporosis by Education Level in a Cohort of Post-menopausal Women. Osteoporos Int.1999;9:236-241.
GnanLcL- Ersoz F.,Gokce- Kutsal Y., Oncel S., Eryavuz M., Peker O., Ok Z. A multicenter case control study of risk factors for low tibia speed of sound among residents of urban areas in Turkey.Rheumatol Int.2002;22:20-6.
Farahmand B. Y., Persson P.G., Michaelsson K., Baron J.A., Parker M.G., junghall S. Socio-economic Status, Marital Status and Hip Fracture Risk: a papulation-based case-control study. Ost-eoporos Int.2000;11: 803-808.
Delmas P.D., Fraser M. Strong bones in later life: luxury or necessity? Bull World Health Organ.1999;77:416-22.
Bonjour J.P. Peak bone mass. Osteoporosis International.1994;4:S7-13.
Rizzoli R. Protein intake during child hood and adolescence and attainment of peak bone mass. Published by Lippincott, Philadelphia.1999; pp:231-43.
Bonjour J.P., Rizzoli R. Bone acquisition in adolescence. Osteoporosis. Published by Academ-ic press, San Diego.1996:pp:465-75.
Armamento-Villareal R. Estrogen status and heredity are major determinants of premenstrual bone mass.J clin Inves.1992;90:2464-71.
Dhuper S. Effects of hormonal status on bone density in adolescent girls. J Clin Endocrinol Metab.1990;71:1083-8.
Ruiz J.C., Mandel C., Grabedian M. Influence of spontaneous calcium intake and physical exer-cise on the vertebral and femoral bone mineral density of children and adolescence. J Bone Miner Res.1995;10:675-82.
Bass S. Exercise before puberty may confer residual benefits in bone density in adulthood: stu-dies in active pre pubertal and retired female gymnasts. J Bone Miner Res.1998;13:500-7.
Matkovic V. Bone status and fracture rates in two regions of Yugoslavia. Am J Clin Nutr. 1979; 32:540-9.
Halioua L., Anderson J.J. Lifetime calcium intake and physical activity habits: independent and combined effects on the radial bone of healt-hy premenopausal Caucasian women. Am J Clin Nutr.1989;49:534-41.
Recker R.R. Bone giant in young adult women. J Am Med. Assoc.1992;268:2403-8.
Saadi H.F., Reed R.L., Carter A.O., Qazaq H. S., Al-Suhaili A.R. Bone density estimates and risk factors for osteoporosis in young women. East Mediterranean Health J.2001;4:730-737.
Finkestein J.S., T.Lee M., Sowers M.F., Hettinger B., Neer R.M., Kelsey J.L., Cauley J.A., Hung M., Greendale G.A. Ethnic Variation in Bone Density in Premenopausal Women: effects of Anthropometric and lifestyle Factor. J Clin Endocrinol Metab.2002;87:3057-3067.
World Health Report, Executive Summary, Conquering suffering, enriching humanity Life expectancy, health expectancy. Word Health Report, Archive.1997-2000.
Person D., Taylor R., Masud T. The relation-ship between social deprivation, osteoporosis, and falls. Osteoporos Int.2004;15:132-8.
Jones S., Johansen A., Brennan J., Butler J., Lyons R.A. The effect of socioeconomic depriva-tion on fracture incidence in the United Kingdom. Osteoporos Int.2004;15:520-524.
Drozdzowska B., Pluskiewica W., Skiba M. Knowledge about osteoporosis in a cohort of Polish females: the influence of age, level of edu-cation and personal experiences. Osteoporos Int. 2004;15:645-8.
Roberts S.E., Goldacre M.J. Time trends and demography of mortality after fractured neck of femur in an English population, 1968-98: database study. BMJ.2003;4:771-5.
Journal of Reproduction & Infertility
Volume 6, Issue 1
Winter 2005
Pages 98-106