Prevalence of osteoporosis in the urban population of Dehradun

1 Dr Ankita Juyal   2 A. N. Sinha   3 Dr Omna Chawla
 Department of Physiology, Government Doon Medical College, Dehradun

INTRODUCTION

Osteoporosis is a silent disease that appears later in life. (Prevalence of osteoporosis in the urban population of Dehradun) It is a condition of skeletal fragility characterized by reduced bone mass and micro architectural deterioration of bone tissue with a consequent increase in risk of fracture.

1. The average risk of osteoporotic fracture for people at 50 years of age has been estimated to be 40% for women, and 13% for men 1 .
2. Deficiency of calcium and vitamin D contributes to alterations of bone remodeling and bone integrity 2 .
3. Dual-Energy X-ray Absorptiometry (DEXA)  bone scan is considered as the gold standard. However, the commonest used modality still remains to be quantitative calcaneal ultrasound as it is cost effective, portable, easily available and lacks the deleterious effect of radiation unlike DEXA 3 .
4. Given the substantial presence of bone loss in Indian population with differing lifestyle habits, there can be regional differences in rates of osteopenia and osteoporosis in India.

AIMs and Objectives

• To explore the prevalence of bone loss i.e., osteopenia and osteoporosis in a nationally representative sample and to find the association of lifestyle with BMD among people living in urban city , we performed this study.

MATERIAL & METHODS (osteoporosis)

1. Apparently healthy, adults (≥18 years) participants of either gender who were not suffering from any disorder known to affect bone health.
2. A standard questionnaire was used to collect information about  sex, age (years), weight (kg), height (cm).
3. Assessment of  bone mineral density of all participants were done by portable ultrasonic bone densitometer. It was performed using heel ultrasound of left foot in each participant.
4. The machine automatically converted the BMD values of the patients into T-Scores.
5. Based on T-score of BMD obtained, participants were labeled as normal (T-score<-1 SD), osteopenia (T-score – 1 to -2.5 SD) and osteoporosis (T-score <-2.5 SD) 4.

Stya Jinda Atma H : सत्य जीवते आत्मा है जो हमें सनातन से जोड़ता है हमारी आत्मा अमर है और ईश्वर का अंश है की याद दिलाता है

References

1. Consensus Development Conference. Diagnosis, Prophylaxis, and Treatment of Osteoporosis. Am J Med. 1993 ;94(6):646–50.
2. C. Pongchaiyakul, V. Kosulwat, S. Charoenkiatkul, L. Chailurkit, N. Rojroongwasinkul, and R. Rajatanavin, “Te association of dietary calcium, bone mineral density and biochemical bone turnover markers in rural Tai women,” Journal of the Medical Association of Thailand, 2008;91(3): 295–302.
3. J J Chitten , B James. Prevalence of Osteopenia and Osteoporosis in Orthopaedic Outpatients in Southern India. Journal of Clinical and Diagnostic Research. 2018; 12(3): 14-17.
4. J. A. Kanis and J. A. Kanis, “Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report,” Osteoporosis International, vol. 4, no. 6, pp. 368–381, 1994.
5. Donescu OS, Battié MC, Videman T, Risteli J, Eyre D. The predictive role of bone turnover markers for BMD in middle-aged men. Aging Male. 2006;9(2):97-102.
6. Holick MF. McCollunm Award lecture 1994: vitamin D-new horizons for the 21st century. Am J Clin Nutr. 1994;60(4):619-30.
7. Demontiero O, Vidal C, Duque G. Aging and bone loss: new insights for the clinician. Ther Adv Musculoskelet Dis. 2012;4(2):61-76.

Conclusion

1. The main finding of the present study is the high prevalence of osteopenia in the  participants (77%) . Many studies  have also shown the importance of detecting osteopenia in the middle age group, as osteopenia could lead to osteoporosis in old age5 . This is explained by genetic susceptibility of Indian population for osteoporosis, high risk of hypovitaminosis D in Indians due to higher 25(OH)-d-24-hydroxylase enzyme and dark pigmentation of their skin which reduces the effect of sunlight exposure 6.
2. The frequency of osteoporosis were more in females as compared to males. In males were 10.7% and in females were 14.08% while the frequency of osteopenia in males were 85.7% and in females were 67.6%. Low BMD is more common in elderly women than in men due to the fact that women have lower BMD to begin with, and the bone loss that occurs with ageing occurs more rapidly, especially after menopause when the protective effect of oestrogen starts to fade 7 .