Log in

Osteoporosis in Indian women aged 40–60 years

  • Original Article
  • Published:
Archives of Osteoporosis Aims and scope Submit manuscript

Abstract

Summary

The study investigates BMD pattern in Indian women aged 40–60 years through a retrospective assessment using DEXA scan of hip and spine of 1,282 asymptomatic Indian women. The Study group indicated high incidence of decreased bone mass and significantly lower BMD as compared to western and other Asian counterparts.

Introduction

An understanding of BMD pattern in women aged 40–60 years is crucial for prevention, diagnosis of osteoporosis and management of its complications in later life. Hence, the present study investigates BMD in Indian women aged 40–60 years for which no data exists in literature.

Method

A retrospective assessment of BMD by DEXA scan of hip and spine of 1,282 asymptomatic women in age group 40–60 was performed. Standardized BMD was calculated and compared with other population groups.

Results

Osteoporosis and osteopenia are widely prevalent among females of the 40–60 age group as a meager 35% of subjects had normal bone density. Average BMD of spine was 0.89 (SD 0.14) gm/cm2 and average BMD of hip was 0.85(0.15) gm/cm2. The correlation between BMD and age was negative. Spine DEXA was found to be more significant than hip DEXA (p value < 0.0001) for osteoporosis assessment. Similarly, T scores of spine were more significantly correlated in this age group (p value < 0.0001) for osteoporosis than hip T scores.

Conclusion

The study group indicated high incidence of decreased bone mass, and significantly lower BMD as compared to western and other Asian counterparts. This study emphasizes on early screening and treatment in study group to avoid long-term complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Liu JH, Muse KN (2005) The effects of progestins on bone density and bone metabolism in postmenopausal women: a randomized controlled trial. Am J Obstet Gynecol 192(4):1316–1324

    Article  CAS  PubMed  Google Scholar 

  2. Takahito N, Tsutomu K, Akira O (2006) Accelerated decrease in bone mineral density in women aged 52–57 years. Tohoku J Exp Med 210:341–347

    Article  Google Scholar 

  3. Jachna C, Patel Abu T (2004) Osteoporosis and perioperative medical management of hip fracture. Curr Opin Orthop 15:2–7

    Article  Google Scholar 

  4. National Osteoporosis Foundation (2002) America’s bone health: the state of osteoporosis and low bone mass in our nation. National Osteoporosis Foundation, Washington

    Google Scholar 

  5. Delaney MF (2006) Strategies for the prevention and treatment of osteoporosis during early postmenopause. Am J Obstet Gynecol 194(2):S12–S23

    Article  PubMed  Google Scholar 

  6. Nochowitz B, Siegert S, Wasik M (2009) An update on osteoporosis. Am J Ther 16(5):437–445

    Google Scholar 

  7. National Osteoporosis Foundation (2008) Clinicians guide to prevention and treatment of osteoporosis. National Osteoporosis Foundation, Washington

    Google Scholar 

  8. Burge RT, Dawson-Hughes B, Solomon D, Wong JB, King AB, Tosteson ANA (2007) Incidence and economic burden of osteoporotic fractures in the United States, 2005–2025. J Bone Min Res 22(3):465–475

    Article  Google Scholar 

  9. Planning commission of India: food and nutrition security, 10th five year plan: Vol 2; chapter 3.3 pp 329

  10. Malhotra N, Mithal A (2008) Review article: osteoporosis in Indians. Indian J Med Res 127:263

    CAS  PubMed  Google Scholar 

  11. Goswami R, Gupta N, Goswami D, Marwaha RK, Tandon N, Kochupillai N (2000) Prevalence and significance of low 25 hydroxyvitamin D concentrations in healthy subjects in Delhi. Am J Clin Nutr 72:472–475

    CAS  PubMed  Google Scholar 

  12. Arya V, Bhambri R, Godbole MM, Mithal A (2004) Vitamin D status and its relationship with bone mineral density in healthy Asian Indians. Osteoporosis Int 15:56–61

    Article  CAS  Google Scholar 

  13. Mitra S, Desai M, Ikram M (2006) Association of estrogen receptor a gene polymorphisms with bone mineral density in postmenopausal Indian women. Mol Genet Metab 87:80–87

    Article  CAS  PubMed  Google Scholar 

  14. Govt of India: Background Papers Of National Commission On Health And Macroeconomics; Ministry Of Health And Family Welfare New Delhi. 2005. Sec iv: pp 241

  15. WHO assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of WHO Study Group. World health organ tech rep ser 1994:1–129

  16. Hui SL, Gao S, Zhou XH, Johnston CC Jr, Lu Y, Gluer CC, Grampp S, Genant H (1997) Universal standardization of bone density measurements: a method with optimal properties for calibration among several instruments. J Bone Miner Res 12:1463–1470

    Article  CAS  PubMed  Google Scholar 

  17. Lu Y, Fuerst T, Hui S, Genant HK (2001) Standardization of bone mineral density at femoral neck, trochanter and Ward’s triangle. Osteoporos Int 12:438–444

    Article  CAS  PubMed  Google Scholar 

  18. Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB et al (1998) Updated data on proximal femur bone mineral levels of US adults. Osteoporos Int 8:468–489

    Article  CAS  PubMed  Google Scholar 

  19. **an-** Wu, Er-Yuan Liao, Hong Zhang, Ru-Chun Dai, Peng-Fei Shan et al (2004) Determination of age-specific bone mineral density and comparison of diagnosis and prevalence of primary osteoporosis in Chinese women based on both Chinese and World Health Organization criteria. J Bone Miner Metab 22:382–391

    Google Scholar 

  20. Mithal A (2003) Editorial “Bone mineral health of Indians”. Natl. Med. J. India 16:3

    Google Scholar 

  21. CDC undated national health and nutrition examination survey available at URL http://www.cdc.gov/nchs/data/nhanes/databriefs/osteoporosis.pdf

  22. Nelson DA, Molloy R, Kleerekoper M (1998) Prevalence of osteoporosis in women referred for bone density testing: utility of multiple skeletal sites. J Clin Densitom 1(1):5–12

    Article  CAS  PubMed  Google Scholar 

  23. Dharmalingam M, Prasanna Kumar KM, Patil J, Karthikshankar S (2003) Study of bone mineral density in postmenopausal women [abstract]. Bone 32(Suppl):S178

    Google Scholar 

  24. Koh SK, Cho SH, Hwang YY (1992) Spinal bone mineral density in normal and osteoporotic women in Korea. J Korean Med Sci 7(2):136–140

    CAS  PubMed  Google Scholar 

  25. Larijani B, Hossein-Nezhad A, Mojtahedi A, Pajouhi M, Bastanhagh MH et al (2005) Normative data of bone mineral density in healthy population of Tehran, Iran: a cross sectional study. BMC musculoskeletal disorders 6:38

    Article  PubMed  Google Scholar 

  26. Keramet A, Bhambhri R, Chakravarty D, Mithal A (2003) Spinal bone mineral density in healthy urban Asian Indian women presenting for a preventive health check-up. J Bone Miner Res 18(Suppl 1):SA083

    Google Scholar 

  27. Sachan A, Gupta R, Das V, Agarwal A, Awasthi PK, Bhatia V (2005) High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India. Am J Clin Nutr 81:1060–1064

    CAS  PubMed  Google Scholar 

  28. Marwaha R, Tandon N, Reddy DR, Aggarwal R, Sawhney RC, Saluja B et al (2005) Vitamin D and bone mineral density status of healthy schoolchildren in northern India. Am J Clin Nutr 82:477–482

    CAS  PubMed  Google Scholar 

  29. Shatrugna V, Kulkarni B, Kumar PA, Rani KU, Balakrishna N (2005) Bone status of Indian women from a low-income group and its relationship to the nutritional status. Osteoporosis Int 16:1827–1835

    Article  Google Scholar 

  30. Harinarayan CV, Ramalakshmi T, Prasad UV, Sudhakar D, Srinivasarao P, Sarma KVS et al (2007) High prevalence of low dietary calcium, high phytate consumption, and vitamin D deficiency in healthy south Indians. Am J Clin Nutr 85:1062–1067

    CAS  PubMed  Google Scholar 

  31. Harinarayan CV (2005) Prevalence of vitamin D insufficiency in postmenopausal south Indian women. Osteoporosis Int 16:397–402

    Article  CAS  Google Scholar 

  32. Ravishankar U (2000) Bone mineral density in normal Indian women: Assessment by dual energy X-ray absorptiometry. In: Sankaran B (ed) Osteoporosis. New Delhi: South East Asia Regional Office, World Health Organization: 20–22.

  33. Mithal A, Nangia S, Arya V, Verma BR, Gujral RB (1998) Spinal bone mineral density in normal Indian females [abstract]. J Bone Miner Res 13(Suppl 1):S591

    Google Scholar 

  34. Pande KC, Johansen KB, Helboe AB (2001) Digital X-ray radiogrammetry: establishment and comparison of Indian female and male normative reference data. J Bone Miner Res 16(Suppl 1):M087

    Google Scholar 

  35. Shah RS, Savardekar L, Iddya U, Balaiah D, Parihar A, Jhankaria B (2004) First Indian study on bone density measurement in Indian women—salient outcomes. Osteoporosis Alert Issue 1:3–4

    Google Scholar 

  36. Reddy PG, Mithal A, Rao DS (2002) Bone mineral density in healthy Asian Indian women: development of a reference database and implications for diagnosis of osteoporosis in Indian women living in the United States [abstract]. J Bone Miner Res 17(Suppl 1):SA270

    Google Scholar 

  37. Marshall D, Johnell O, Wedel H (1996) Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. Bm J 312(7041):1254–1259

    CAS  Google Scholar 

  38. Leslie WD, Tsang JF, Caetano PA, Lix LM (2007) Effectiveness of bone density measurement for predicting osteoporotic fractures in clinical practice. J Clin Endocrinol Metab 92(1):77–81

    Article  CAS  PubMed  Google Scholar 

  39. Schneider DL (2006) Clinical utility of spine bone density in elderly women. J Clin Densitom 9(3):255–260

    Article  PubMed  Google Scholar 

  40. Nevitt MC, Ettinger B, Black DM, Stone K, Jamal SA, Ensrud K, Segal M, Genant HK, Cummings SR (1998) The association of radiographically detected vertebral fractures with back pain and function: a prospective study. Ann Intern Med 128:793–800

    CAS  PubMed  Google Scholar 

  41. De Negri P, Tirri T, Paternoster G, Modano P (2007) Treatment of painful osteoporotic or traumatic vertebral compression fractures by percutaneous vertebral augmentation procedures: a nonrandomized comparison between vertebroplasty and kyphoplasty. Clin J Pain 23(5):425–430

    Article  PubMed  Google Scholar 

  42. Garfin SR, Buckley RA, Ledlie J (2006) Balloon kyphoplasty for symptomatic vertebral body compression fractures results in rapid, significant, and sustained improvements in back pain, function, and quality of life for elderly patients: The Balloon Kyphoplasty Outcomes Group. Spine 31(19):2213–2220

    Article  PubMed  Google Scholar 

  43. U.S. Preventive Services Task Force (2002) Screening for osteoporosis in postmenopausal women: recommendations and rationale. Ann Intern Med 137(6):526–528

    Google Scholar 

Download references

Acknowledgment

The authors gratefully acknowledge the inputs of Ms Nirajana Mishra for statistical analysis of this study.

Disclosure of conflicts

Authors do not have any conflict of interest. No disclosures.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shankar Acharya.

Additional information

This work was done by the co-author in his previous capacity as Fellow, Spine Society—Delhi Chapter, New Delhi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Acharya, S., Srivastava, A. & Sen, I.B. Osteoporosis in Indian women aged 40–60 years. Arch Osteoporos 5, 83–89 (2010). https://doi.org/10.1007/s11657-010-0037-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11657-010-0037-5

Keywords

Navigation