Document Type : Original Article
Authors
- . Elnaz Hemmati 1
- . Mojgan Mirghafourvand 2
- . Majid Mobasseri 3
- . Seyed Kazem Shakouri 4
- . Parvaneh Mikaeli 5
- . Azizeh Farshbaf‑Khalili 4
1 Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
2 Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
3 Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
4 Physical Medicine and Rehabilitation Research Centre, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
5 , Bone Densitometry Center, Sina Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
BACKGROUND: Globally, 30% of female over 50 years old have osteoporosis. This disease is one
of the major causes of disability and death in the elderly. This research was aimed to determine
the prevalence of primary osteoporosis and low bone density based on bone mineral density in
postmenopausal women and its sociodemographic, obstetric, and life style risk factors.
MATERIALS AND METHODS: This cross-sectional descriptive-analytical study was performed by
simple random sampling on 850 postmenopausal women aged 50–65 years covered by all health
centers, from August 2018 to April 2019, in Tabriz-Iran. Four hundred and forty-five eligible women
underwent densitometry using dual-energy X-ray absorptiometry in the lumbar spine and femoral
neck. Socio-individual, obstetric-medical, international physical activity questionnaires-short form,
and anthropometric questionnaires were completed. Data analyzed using descriptive and analytical
statistics including multivariate logistic regression in SPSS 21 software.
RESULTS: The prevalence of primary osteoporosis based on lumbar vertebra T-score, femoral
neck T-score, and total was 23.4%, 3.4%, and 24.5%, respectively, and the prevalence of primary
osteopenia based on lumbar vertebra T-score, femur neck T-score, and total was 42%, 35.5%, and
43.6%, respectively. The present study showed that the odds of osteoporosis increased by increment
of age (odds ratio [OR]: 1.18; 95% confidence interval [CI]: 1.07–1.30), but it decreased by increasing
menopausal age (OR: 0.92; 95% CI: 0.85–1.01), body mass index (OR: 0.87; 95% CI: 0.78–0.97),
arm circumference (OR: 0.84; 95% CI: 0.74–0.95), and education level (P = 0.028). It was higher in
unmarried women (OR: 2.65; 95% CI: 0.99–7.08) and those with nonpersonal housing (OR: 4.02;
95% CI: 1.24–13.07).
CONCLUSIONS: Given the high prevalence of primary osteoporosis and low bone mass in postmenopausal
women, health education is necessary for preventing modifiable risk factors and reducing the complications
of this disease.
Keywords
testosterone concentrations in adult males with or without
primary osteoporosis: A meta‑analysis. Biomed Res Int.
2017;2017:9892048. doi: 10.1155/2017/9892048
2. Jahromi VK, Ghashghaei SB, Sharifi N. Improvement of
osteoporosis‑related behaviors in female students based on trans
theoretical model. J Educ Health Promot. 2020;9:221. 3. Jin YX, Wu P, Mao YF, Wang B, Zhang JF, Chen WL, Liu Z, Shi XL.
Chinese herbal medicine for osteoporosis: A meta‑analysis of
randomized controlled trials. Journal of Clinical Densitometry.
2017;20:516‑25.
4. Tian L, Yang R, Wei L, Liu J, Yang Y, Shao F, et al. Prevalence
of osteoporosis and related lifestyle and metabolic factors of
postmenopausal women and elderly men: A cross‑sectional study
in Gansu province, Northwestern of China. Medicine (Baltimore)
2017;96:e8294.
5. Compston J, Cooper A, Cooper C, Gittoes N, Gregson C,
Harvey N, et al. UK clinical guideline for the prevention and
treatment of osteoporosis. Arch Osteoporos 2017;12:43.
6. Chawla J, Sharma N, Arora D, Arora M, Shukla L. Bone
densitometry status and its associated factors in peri and post
menopausal females: A cross sectional study from a tertiary care
centre in India. Taiwan J Obstet Gynecol 2018;57:100‑5.
7. Cui W, Mager J. Transcriptional regulation and genes involved in
first lineage specification during preimplantation development.
Adv Anat Embryol Cell Biol 2018;229:31‑46.
8. Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R,
Reginster JY, et al. European guidance for the diagnosis and
management of osteoporosis in postmenopausal women.
Osteoporos Int 2013;24:23‑57.
9. Pajouhi M, Maghbooli Z, Hejri SM, Keshtkar A, Saberi M,
Larijani B. Bone mineral density in 10 to75 year‑old Iranian
healthy women: Population base study. Iran J Public Health
2004;33 Suppl 1:57‑63.
10. Paknahad Z, Mohammadifard N, Bonakdar Z, Hasanzadeh A.
Nutritional status and its relationship with bone mass density in
postmenopausal women admitted in osteodensitometry center,
Isfahan‑Iran. J Educ Health Promot 2014;3:48.
11. Tohidi M, Dabbaghmanesh MH, Fattahi MR, Ranjbar Omrani G.
Prevalence of osteoporosis in rural men of Fars based on both local
and WHO reference data. Iran J Endocrinol Metab 2010;12:393‑400.
12. Ensrud KE. Epidemiology of fracture risk with advancing age J
Gerontol A Biol Sci Med Sci 2013;68:1236‑42.
13. Wright NC, Looker AC, Saag KG, Curtis JR, Delzell ES, Randall S,
et al. The recent prevalence of osteoporosis and low bone mass in
the United States based on bone mineral density at the femoral
neck or lumbar spine. J Bone Mineral Res 2014;29:2520‑6.
14. Dionyssiotis Y, Paspati I, Trovas G, Galanos A, Lyritis GP.
Association of physical exercise and calcium intake with bone
mass measured by quantitative ultrasound. BMC Women’s Health
2010;10:12.
15. Chang HC, Hsieh CF, Lin YC, Tantoh DM, Ko PC, Kung YY,
et al. Does coffee drinking have beneficial effects on bone health
of Taiwanese adults? A longitudinal study. BMC Public Health
2018;18:1273.
16. Naseh L, Shaikhy R, Rafiei H. General self‑efficacy and associated
factors among elderly residents of nursing home. J Holistic Nurs
Midwifery 2016;26:90‑7.
17. Harooni J, Hassanzadeh A, Mostafavi F. Influencing factors
on health promoting behavior among the elderly living in the
community. J Educ Health Promot 2014;3:40.
18. Rabiei L, Mostafavi F, Masoudi R, Hassanzadeh A. Effects of
family‑centered interventions on empowerment of the elderly.
J Educ Health Promot 2013;2:24.
19. Stanhope M, Lancaster J. Community & public health nursing.
6th ed., St. Louis: Mosby; 2004.
20. Kular J, Tickner J, Chim SM, Xu J. An overview of the regulation
of bone remodelling at the cellular level. Clin Biochem
2012;45:863‑73.
21. Bagheri P, Haghdoost A, Dortaj rabari E, Halimi L, Vafaei Z,
Farhangnya M, et al. Ultra analysis of prevalence of osteoporosis
in Iranian women “a systematic review and meta‑analysis. Iran
J Endocrinol Metabolism 2011;13:315‑42.
22. Statistical Year Book of Iran Publication of Statistical Center;
Statistical Center of Iran; 2007.
23. Hemmati F, Sarokhani D, Sayehmiri K, Motadayen M. Prevalence
of osteoporosis in postmenopausal women in Iran: A systematic
review and meta‑analysis. Iran J Obstetrics Gynecol Infertility
2018;21:90‑102.
24. Statistical Center of Iran. The Results of the General Census of
Population and Housing; 2016. Available from: https://www.
amar.org.ir/ [Last accessed on 2020 Oct 03].
25. Bayat N, Haji AZ, Ali SG, Ebadi A, Hosseini M, Lalouei A.
Frequency of Osteoporosis and Osteopenia in Post‑Menopausal
Military Family’s Women; 2008.
26. WHO Study Group. Assessment of Fracture Risk and its Application
to Screening for Postmenopausal Osteoporosis. Technical Report
Series 843. Geneva: World Health Organization; 1994.
27. Hazavehei SM, Asadi Z, Hassanzadeh A, Shekarchizadeh P.
Comparing the effect of two methods of presenting physical
education Π course on the attitudes and practices of female
Students towards regular physical activity in Isfahan University
of Medical Sciences. Iran J Med Edu 2008;8:121‑31.
28. Committee IR. Guidelines for data processing and analysis of the
international physical activity questionnaire (IPAQ)‑short and
long forms. Retrieved Sept 2005;17:2008.
29. Wade SW, Strader C, Fitzpatrick LA, Anthony MS, O’Malley CD.
Estimating prevalence of osteoporosis: Examples from
industrialized countries. Arch Osteoporos 2014;9:182.
30. El-Hajj Fuleihan G, Adib G, Nauroy L. (2011). The middle
east & Africa regional audit, epidemiology, costs & burden of
osteoporosis in 2011. International Osteoporosis Foundation,
Switzerland: pp. 102011–105000.
31. Chen PH, Lin MS, Huang TJ, Chen MY. Prevalence of and factors
associated with adopting bone health promoting behaviours
among people with osteoporosis in Taiwan: A crosssectional
study. BMJ Open 2017;7:e01598030.
32. Irani AD, Poorolajal J, Khalilian A, Esmailnasab N, Cheraghi Z.
Prevalence of osteoporosis in Iran: A meta‑analysis. J Res Med
Sci 2013;18:759‑66.
33. Jamshidian TM, Kalantari N, Kamali Z, Houshyarrad A,
Azadbakht L, Smaeilzadeh A, et al. Osteoporosis risk factors in
Tehran women aged 40‑60 years. IJEM 2004;6(2):139‑45.
34. Dempster DW. Osteoporosis and the burden of osteoporosis‑related
fractures. Am J Manag Care 2011;17 Suppl 6:S164‑9.
35. Morin SN, Lix LM, Leslie WD. The importance of previous fracture
site on osteoporosis diagnosis and incident fractures in women.
J Bone Miner Res 2014;29:1675‑80.
36. Bazrafshan HR, Qorbani M, Shadpour Rashti H, Aghaei M,
Safari R. Prevalence of osteoporosis and its association with
demographic characterirstics – Gorgan, Iran. J Hormozgan Uni
Med Sci 2011;15:56‑62.
37. Ajamzibod H. The study of relationship between life style and
quality of life among the west Tehran elderly. [PhD dissertation,
MSc. thesis]. Tehran: Tehran University of Medical Sciences,
2011.
38. Lloyd JT, Alley DE, Hawkes WG, Hochberg MC, Waldstein SR,
Orwig DL. Body mass index is positively associated with
bone mineral density in US older adults. Arch Osteoporos
2014;9:175.
39. Kameda T, Mano H, Yuasa T, Mori Y, Miyazawa K, Shiokawa M,
et al. Estrogen inhibits bone resorption by directly inducing
apoptosis of the bone‑resorbing osteoclasts. J Exp Med
1997;186:489‑95.
40. Naeem ST, Hussain R, Raheem A, Siddiqui I, Ghani F, Khan AH.
Bone turnover markers for osteoporosis status assessment at
baseline in postmenopausal Pakistani females. J Coll Physicians
Surg Pak 2016;26:408‑12.
41. Liu ZM, Wong CK, Wong SY, Leung J, Tse LA, Chan R, et al.
A healthier lifestyle pattern for cardiovascular risk reduction is
associated with better bone mass in Southern Chinese elderly men and women. Medicine (Baltimore) 2015;94:e1283.
42. Yu CX, Zhang XZ, Zhang K, Tang Z. A cross‑sectional study
for estimation of associations between education level and
osteoporosis in a Chinese men sample. BMC Musculoskelet
Disord 2015;16:382.
43. Hasnah H, Amin I, Suzana S. Bone health status and lipid profile
among post‑menopausal malay women in Cheras, Kuala Lumpur.
Malays J Nutr 2012;18:161‑71.
)